足部穴位热熨对肿瘤患者全麻术后低体温恢复的干预研究
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摘要
目的近年来,中医干预低体温取得一定进展。足部穴位丰富,是中医外治常选机体部位,本研究分析足部穴位热熨对肿瘤患者全麻术后低体温的影响,为今后术后低体温干预提供参考。方法采用前瞻性研究,根据本研究相关标准将2016年1月—2017年6月浙江中医药大学附属第二医院肿瘤外科收治全麻手术患者纳入研究(80例),采用抽签的方式随机分为2组,对照组行室温控制、加盖被褥等常规护理,观察组在其基础制作艾盐包,经恒温箱加热后用小毛巾包裹,在涌泉穴、冲阳穴分别热熨20 min,记录术前及返回病房时体温、足背温度,记录体温、足部皮肤恢复至基础体温所用时间及寒战消退时间、患者主观寒冷感消退时间;评估2组寒战发生程度,调查护理满意度。结果 2组患者术前及返回病房时体温、足背部皮肤温度差异均无统计学意义(均P>0.05);观察组体温、足背部温度恢复到基础体温所用时间较对照组短(均P<0.001);观察组寒战消退时间、主观寒冷感消退消失时间均较对照组短(均P<0.001);观察组3级寒战发生率为15.00%,较对照组(30.00%)低(χ~2=2.581,P=0.108),2组寒战总发生率和三级寒战发生率比较差异无统计学意义(均P>0.05);护理满意率(90.00%)较对照组(72.50%)高,差异有统计学意义(χ~2=4.021,P=0.045)。结论足部穴位热熨护理能促进肿瘤患者全麻术后低体温复常,尽快消除寒战及低体温带给患者的不适感,减少严重寒战的发生,提高护理满意度。
Objective In recent years,some progress has been made in the intervention of traditional Chinese medicine on hypothermia.Foot points are abundant,which is a common body part for external treatment of traditional Chinese medicine.This study analyzed the effect of foot heat ironing on hypothermia in patients with tumor after general anesthesia,thus to provide reference for postoperative hypothermia intervention.Methods According to the relevant criteria of this study,80 patients with general anesthesia in our hospital were randomly divided into two groups by drawing lots,and the control group was controlled by room temperature.Routine nursing care,such as covering bedding and so on,was used in the observation group.After heating in the incubator,the observation group was wrapped with a small towel and ironed for 20 minutes at the points of Yongquan and Chongyang respectively.The temperature of the patients before operation and returning to the ward was recorded,and the temperature of the foot back was recorded,and the temperature of the foot was recorded,as well as the recovery time of foot skin to basic body temperature and the time of shivering retreat,the time of subjective cold feeling regression,the evaluation of the degree of shivering in the two groups,and the investigation of nursing satisfaction.Results There was no significant difference in body temperature and skin temperature between the two groups before operation and back to ward(all P > 0.05),the time to recover back temperature to basic body temperature in the observation group was shorter than that in the control group(all P < 0.001),and the time of shivering subsiding in the observation group was less than that in the control group.The disappearance time of subjective cold feeling was shorter than that of the control group(all P < 0.001),the rate of shivering in the observation group was 15.00%,which was lower than 30.00%in the control group(χ~2= 2.581,P = 0.108),and the nursing satisfaction rate(90.00%) was higher than(72.50%) in the control group(χ~2= 4.021,P = 0.045).Conclusion The nursing care of foot hot ironing can promote hypothermia of tumor patients after general anesthesia,eliminate the discomfort caused by shivering and hypothermia as soon as possible,reduce the occurrence of severe shivering,and improve nursing satisfaction.
Objective In recent years,some progress has been made in the intervention of traditional Chinese medicine on hypothermia.Foot points are abundant,which is a common body part for external treatment of traditional Chinese medicine.This study analyzed the effect of foot heat ironing on hypothermia in patients with tumor after general anesthesia,thus to provide reference for postoperative hypothermia intervention.Methods According to the relevant criteria of this study,80 patients with general anesthesia in our hospital were randomly divided into two groups by drawing lots,and the control group was controlled by room temperature.Routine nursing care,such as covering bedding and so on,was used in the observation group.After heating in the incubator,the observation group was wrapped with a small towel and ironed for 20 minutes at the points of Yongquan and Chongyang respectively.The temperature of the patients before operation and returning to the ward was recorded,and the temperature of the foot back was recorded,and the temperature of the foot was recorded,as well as the recovery time of foot skin to basic body temperature and the time of shivering retreat,the time of subjective cold feeling regression,the evaluation of the degree of shivering in the two groups,and the investigation of nursing satisfaction.Results There was no significant difference in body temperature and skin temperature between the two groups before operation and back to ward(all P > 0.05),the time to recover back temperature to basic body temperature in the observation group was shorter than that in the control group(all P < 0.001),and the time of shivering subsiding in the observation group was less than that in the control group.The disappearance time of subjective cold feeling was shorter than that of the control group(all P < 0.001),the rate of shivering in the observation group was 15.00%,which was lower than 30.00%in the control group(χ~2= 2.581,P = 0.108),and the nursing satisfaction rate(90.00%) was higher than(72.50%) in the control group(χ~2= 4.021,P = 0.045).Conclusion The nursing care of foot hot ironing can promote hypothermia of tumor patients after general anesthesia,eliminate the discomfort caused by shivering and hypothermia as soon as possible,reduce the occurrence of severe shivering,and improve nursing satisfaction.
引文
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[19]刘丹,徐海艳.电针结合艾灸涌泉穴治疗脑卒中后足下垂的临床观察[J].针灸临床杂志,2014,17(3):8-9.
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[2]陈改平,杨郁文,汪永坚,等.足部穴位艾灸对妇科全麻患者术后寒战和足温恢复的影响[J].浙江中医药大学学报,2014,27(10):1236-1237,1238.
[3]魏艳霞,张保朝,周静,等.针灸百会、涌泉穴治疗老年性痴呆的临床效果[J].中国老年学杂志,2016,36(12):2916-2917.
[4]刘亚魁,牟作峰,陈艳,等.吴茱萸末贴敷双侧涌泉穴对减轻全膝关节置换术后下肢肿胀的效果观察[J].河北中医,2017,39(3):428-431.
[5]陈芳,许永红,杨玉佩,等.吴茱萸外敷涌泉穴治疗妊娠剧吐疗效观察[J].护理研究,2014,28(5):594.
[6]赵吉华,朱静娟.耳穴埋豆和涌泉穴按摩对原发性高血压的疗效及其护理干预[J].中华全科医学,2014,12(8):1337-1338.
[7]张慧兰.吴茱萸贴敷涌泉穴防治艾素静脉化疗患者失眠症的临床观察[J].上海针灸杂志,2014,33(3):204-205.
[8]张洁,张玲霖,李德华,等.涌泉穴治疗慢性咽炎的机理探讨[J].针灸临床杂志,2014,23(12):35-37.
[9]蚁淳,冯细强,叶大庆,等.新型桂蜡热敷涌泉穴法治疗糖尿病周围神经病变疗效观察[J].护理研究,2016,30(23):2862-2866.
[10]余鸿斌,于柏清,杜振欢,等.涌泉穴烧山火针法治疗脊髓损伤临床观察[J].上海针灸杂志,2015,18(8):773-774.
[11]孟琴秋.吴茱萸粉涌泉穴贴敷对骨科患者术前睡眠的影响[J].上海针灸杂志,2014,27(12):1127-1128.
[12]HU L T,TSIBRIS A M,BRANDA J A.Case records of the massachusetts general hospital.Case 24-2015:a 28-year-old pregnant woman with fever,chills,headache,and fatigue[J].N Engl J Med,2015,373(5):468-475.
[13]崔宇红,李芳.艾灸联合赤小豆贴敷治疗脊柱病术后尿潴留43例疗效观察及护理体会[J].中国妇幼保健,2014,29(17):2820-2821.
[14]MERY M.Venezuela strife chills outside investment[J].Platt's Oilgram News,2015,93(38):4.
[15]张晶,孙岩,张永臣,等.自行研制艾灸测温仪在实验教学中的应用[J].中国针灸,2017,37(4):437-439.
[16]陈冬梅,莫新少,陈似霞,等.大肝癌术后低温患者复温效果与其体质量指数的相关性研究[J].中国实用护理杂志,2016,32(11):819-822.
[17]COPUR M,TURAN A,ERUSLU M N,et al.Effects of chills on the solidification pattern of an axial steel cast impeller[J].Metalurgija,2015,54(3):515-518.
[18]夏颖,章茶琴.足三里联合三阴交艾灸促进腹部术后胃肠功能恢复的观察[J].上海针灸杂志,2014,33(6):518-519.
[19]刘丹,徐海艳.电针结合艾灸涌泉穴治疗脑卒中后足下垂的临床观察[J].针灸临床杂志,2014,17(3):8-9.
[20]李春燕.术后无温差输液护理对开腹胆囊手术患者术后低体温及并发症的影响[J].海南医学,2015,26(19):2961-2962.