老年患者下肢骨折术中保温干预对术后寒战、隐性失血发生率的影响

Effects of intraoperative thermal insulation on incidence of postoperative shivering and hidden hemorrhage in elderly patients with lower limb fracture

中文关键词: 老年  下肢骨折  术中保温  寒战  隐性失血

英文关键词: elderly  lower limb fracture  intraoperative thermal insulation  shivering  hidden hemorrhage

中文摘要:

      目的 探究在老年下肢骨折术中实施术中保温对术后寒战、隐性失血的影响,为治疗该类病症提供方法.方法 选取2021 年3 月—2023 年1 月在中国人民解放军联勤保障部队第九六四医院行手术治疗的108 例老年下肢骨折患者,随机数字表法分成对照组与观察组,每组54 例,术中2 组患者分别进行常规干预与保温干预.分别于入室(T0)、开始手术(T1)、术中30 min(T2)、术中60 min(T3)、结束手术(T4)测量患者体温,比较2 组凝血功能、临床指标及寒战发生状况.结果 T1～T4 时刻,2 组体温变化时间、组间及交互差异显著(P＜0.05).手术后,观察组凝血活酶时间、凝血酶原时间、凝血酶时间及纤维蛋白原水平均低于对照组,血小板计数水平高于对照组(P＜0.05);观察组术中出血、隐性失血及切口引流量与寒战发生率均低于对照组,热舒适度评分显著高于对照组(P＜0.05),2 组输血例数无显著差异(P＞0.05).结论 对老年下肢骨折患者进行术中保温干预效果较好,能有效预防术后寒战的发生,保持机体凝血功能稳定,减少隐性失血量,具有一定临床价值.

英文摘要:

      Objective To investigate the effects of intraoperative thermal insulation on the incidence of postoperative shivering and hidden hemorrhage in elderly patients with lower limb fracture.Methods A total of 108 elderly patients with lower limb fracture who underwent surgical treatment in No.964 Hospital of Joint Logistics Support Force from March 2021 to January 2023 were selected,and randomly divided into control group(54 cases)and observation group(54 cases).During the operation,the patients of the two groups were treated with routine intervention and thermal insulation intervention,respective-ly.The patients'temperature was measured on entering the operating room(T0),at the beginning of operation(T1),at 30 min after the beginning of operation(T2),at 60 min after the beginning of operation(T3)and at the end of operation(T4),respectively.Coagulation function,clinical indexes and the incidence of shivering were compared between the two groups.Results From T1 to T4,the body temperature change time and the differences between the two groups were significant(P＜0.05).After operation,activated partial thromboplastin time,prothrombin time,thrombin time and fibrinogen level of the ob-servation group were shorter or lower than those of the control group,and platelet count was higher than that of the control group(P＜0.05).Intraoperative blood loss,hidden blood loss,incision drainage volume,and the incidence of shivering of the observation group were less or lower than those of the control group,and thermal comfort score was higher than that of the con-trol group(P＜0.05).There was no significant difference in the number of blood transfusion cases between the two groups(P＞0.05).Conclusion The effect of intraoperative thermal insulation intervention on elderly patients with lower limb frac-tures is good,which can effectively prevent the occurrence of postoperative shivering,stabilize coagulation function,reduce hidden blood loss,and has certain clinical value.