TURP术中不同体温对老年患者术后谵妄的影响
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摘要
目的探讨前列腺气化电切手术(TURP)术中不同体温对老年患者术后谵妄的影响。方法选择我院2017年1月—2018年1月拟行TURP手术的老年患者80例,按照随机数字表法均分为室温组和加温组,各40例。两组均给予喉罩全麻,均给予常规保温措施,室温组的膀胱冲洗液和静脉输注液均为室温液(25℃),加温组的膀胱冲洗液和静脉输注液均为加温液(37℃),术中连续测量两组患者术中的鼻咽温度,记录患者术后谵妄和寒颤发生情况。结果室温组术后鼻咽温度为(34.52±0.23)℃,低于加温组的(36.29±0.28)℃(P<0.05)。加温组寒颤和谵妄发生率分别为10.00%、7.50%,低于室温组的55.00%、27.50%(P <0.05)。结论在TURP手术,给予老年患者加温保护措施有助于维持患者鼻咽温度,减少术后寒颤和谵妄发生率。
Objective To investigate the effects of different body temperature during postoperative prostate gastrectomy(TURP) on postoperative delirium in elderly patients. Methods 80 patients who underwent TURP surgery from January 2017 to January 2018 in our hospital were divided into room temperature group and heating group according to the random number table method, 40 cases in each group. Both groups were given general anesthesia in the laryngeal mask. All routine warming measures were given. The bladder flushing solution and intravenous infusion solution in the room temperature group were both room temperature solution(25 ℃), the bladder rinse and intravenous infusion of the warming group were treated by heating(37 ℃), intraoperative nasopharynx temperature was measured continuously in the two groups, and postoperative delirium and chills were recorded. Results The postoperative nasopharyngeal temperature was(34.52±0.23)℃ in the room temperature group, which was significantly lower than(36.29±0.28) ℃ in the warming group(P < 0.05). The incidence of chills and delirium in the warming group were 10.00% and 7.50%, respectively, which were significantly lower than 55.00% and 27.50% of the control group(P < 0.05). Conclusion During TURP surgery, warming protection measures for elderly patients help maintain the patient's nasopharyngeal temperature and reduce the incidence of postoperative chills and delirium.
Objective To investigate the effects of different body temperature during postoperative prostate gastrectomy(TURP) on postoperative delirium in elderly patients. Methods 80 patients who underwent TURP surgery from January 2017 to January 2018 in our hospital were divided into room temperature group and heating group according to the random number table method, 40 cases in each group. Both groups were given general anesthesia in the laryngeal mask. All routine warming measures were given. The bladder flushing solution and intravenous infusion solution in the room temperature group were both room temperature solution(25 ℃), the bladder rinse and intravenous infusion of the warming group were treated by heating(37 ℃), intraoperative nasopharynx temperature was measured continuously in the two groups, and postoperative delirium and chills were recorded. Results The postoperative nasopharyngeal temperature was(34.52±0.23)℃ in the room temperature group, which was significantly lower than(36.29±0.28) ℃ in the warming group(P < 0.05). The incidence of chills and delirium in the warming group were 10.00% and 7.50%, respectively, which were significantly lower than 55.00% and 27.50% of the control group(P < 0.05). Conclusion During TURP surgery, warming protection measures for elderly patients help maintain the patient's nasopharyngeal temperature and reduce the incidence of postoperative chills and delirium.
引文
[1]王聿加,王敏欢,马丙强.体温保护对老年胃癌根治术患者术后躁动和谵妄的影响[J].世界最新医学信息文摘,2018,18(58):38-39,41.
[2]杨木强,闫俊强,司马靓杰,等.术中体温保护对老年前列腺气化电切手术患者术后早期认知功能及血清脑损伤标志物的影响[J].安徽医学,2018,39(5):509-513.
[3]朱鸣雷,黄宇光,刘晓红,等.老年患者围手术期管理北京协和医院专家共识[J].协和医学杂志,2018,9(1):36-41.
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[6]林秀珍,李爽,李岩.护理干预措施在老年前列腺电切手术患者术中低体温中的应用效果[J].中国实用医药,2015,10(29):250-251.
[7]毛艳.后腹腔镜肾上腺肿瘤切除术的围手术期护理[J].中国卫生标准管理,2018,9(15):176-178.
[8]王霞,李新辉,黄和平,等.膀胱冲洗液温度对老年病人经尿道前列腺电切术术后并发症的影响[J].全科护理,2014,12(11):986-988.
[9]张雪峰.不同温度冲洗液对老年前列腺电切患者术后膀胱痉挛的影响[J].护理实践与研究,2015,12(11):58-59.
[10]张玉杰,杨宇.老年患者前列腺电切手术期间体温保护的临床观察[J].第三军医大学学报,2016,38(18):2096-2099.
[11]赵冰芝.专项护理措施在预防开胸手术低体温方面的效果评价[J].中国卫生标准管理,2018,9(18):172-173.
[12]李俊霞,王兰平.膀胱冲洗液温度对前列腺电切手术患者体温的影响[J].临床合理用药杂志,2017,10(31):23-26.
[13]张瑛,李金娜,白莉平,等.综合保温措施预防老年患者前列腺电切围手术期低体温的研究[J].山西医科大学学报,2015,46(5):492-494.
[2]杨木强,闫俊强,司马靓杰,等.术中体温保护对老年前列腺气化电切手术患者术后早期认知功能及血清脑损伤标志物的影响[J].安徽医学,2018,39(5):509-513.
[3]朱鸣雷,黄宇光,刘晓红,等.老年患者围手术期管理北京协和医院专家共识[J].协和医学杂志,2018,9(1):36-41.
[4]李东白,李莎,高露露,等.不同体温及PaCO_2对老年患者腹腔镜术后早期精神改变的影响[J].大连医科大学学报,2017,58(5):465-470.
[5]戈丽丽,芮琳.灌洗液加温与充气温毯对老年患者前列腺电切手术中体温保护的比较[J].当代护士,2017,13(12):118-120.
[6]林秀珍,李爽,李岩.护理干预措施在老年前列腺电切手术患者术中低体温中的应用效果[J].中国实用医药,2015,10(29):250-251.
[7]毛艳.后腹腔镜肾上腺肿瘤切除术的围手术期护理[J].中国卫生标准管理,2018,9(15):176-178.
[8]王霞,李新辉,黄和平,等.膀胱冲洗液温度对老年病人经尿道前列腺电切术术后并发症的影响[J].全科护理,2014,12(11):986-988.
[9]张雪峰.不同温度冲洗液对老年前列腺电切患者术后膀胱痉挛的影响[J].护理实践与研究,2015,12(11):58-59.
[10]张玉杰,杨宇.老年患者前列腺电切手术期间体温保护的临床观察[J].第三军医大学学报,2016,38(18):2096-2099.
[11]赵冰芝.专项护理措施在预防开胸手术低体温方面的效果评价[J].中国卫生标准管理,2018,9(18):172-173.
[12]李俊霞,王兰平.膀胱冲洗液温度对前列腺电切手术患者体温的影响[J].临床合理用药杂志,2017,10(31):23-26.
[13]张瑛,李金娜,白莉平,等.综合保温措施预防老年患者前列腺电切围手术期低体温的研究[J].山西医科大学学报,2015,46(5):492-494.