| 王 辉,魏 勇,王陈芳,袁 希,徐 科.综合体温管理对老年肺癌患者凝血功能、失血量及早期认知功能的影响研究[J].,2018,(13):2522-2526 |
| 综合体温管理对老年肺癌患者凝血功能、失血量及早期认知功能的影响研究 |
| Effect of General Management of Body Temperature on Coagulation Function, Blood Loss Volume and Early Cognitive Function of Senile Patients with Lung Cancer |
| 投稿时间：2017-09-13 修订日期：2017-09-30 |
| DOI：10.13241/j.cnki.pmb.2018.13.025 |
| 中文关键词: 体温 综合管理 肺癌 凝血功能 失血量 认知功能 |
| 英文关键词: Body temperature General management Lung cancer Coagulation function Blood Loss Volume Cognitive function |
| 基金项目:四川省卫计委科研基金资助项目（100109） |
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| 中文摘要: |
| 摘要 目的：观察综合体温管理对老年肺癌患者凝血功能、失血量及早期认知功能的影响。方法：148例老年肺癌手术患者随机分为观察组（n=74）与对照组（n=74）。对照组予常规管理，观察组予综合体温管理。观察两组术前（t1）、开胸后（t2）、冲洗前（t3）、冲洗后（t4）、关胸后（t5）的鼻咽温度、肛门温度和血氧饱和度；术前、手术30 min、术后即刻凝血功能指标；术中、术后1d、术后2d失血量；术前术后认知功能评分；麻醉恢复期寒战及术后感染发生率。结果：t1、t2时，两组鼻咽温度、肛门温度、血氧饱和度差异无统计学意义（P＞0.05）。t3、t4、t5时，观察组鼻咽温度、肛门温度、血氧饱和度均高于对照组，差异有统计学意义（P＜0.05）。手术30 min、术后，两组凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）等凝血功能指标均降低，观察组PT、APTT、TT等凝血功能指标均低于对照组，差异有统计学意义（P＜0.05）。观察组术中、术后1d、术后2d失血量均分别低于对照组，差异有统计学意义（P＜0.05）。观察组术后认知功能评分高于对照组，差异有统计学意义（P＜0.05）。观察组麻醉恢复期寒战发生率8.11%低于对照组27.03%，差异有统计学意义（P＜0.05），术后感染率4.05%低于对照组16.22%，差异有统计学意义（P＜0.05）。结论：综合体温管理可有效维持老年肺癌患者术中正常核心体温，维持血液、神经等系统的正常生理功能，提高患者术后早期认知功能，降低围术期风险。 |
| 英文摘要: |
| ABSTRACT Objective: To observe the effect of general management of body temperature on coagulation function, blood loss volume and early cognitive function of senile patients with lung cancer. Methods: A total of 148 senile patients with lung cancer were randomly divided into control group(n=74) and observation group(n=74). The control group was given routine management, and the observation group was given general management of body temperature. The nasopharynx temperature, anus temperature and oxyhemoglobin saturation were observed before (t1) and after (t2) operation, before (t3) and after (t4) irrigation, and after closing the chest(t5); the coagulation functional indicators were recorded before operation, at 30min of operation and after operation; The blood loss volume was recorded during the operation, d1 and d2 after operation and cognitive function scores before and after operation were also recorded; the shiver during anesthesia recovery period and occurrence rate of postoperative infection of the two groups were observed. Results: There were no statistical differences in nasopharynx temperature, anus temperature and oxyhemoglobin saturation at t1 and t2 between the two groups (P>0.05). The nasopharynx temperature, anus temperature and oxyhemoglobin saturation of patients in the observation group at t3, t4 and t5 were higher than those in the control group, and the difference was statistically significant (P＜0.05). The coagulation functional indicators such as prothrombin time(PT), activated partial thromboplastin time (APTT) and thrombin time(TT) of the two groups decreased 30 min during operation and after operation, and the above indexes in the observation group were lower than those in the control group (P＜0.05). Blood loss volume of the observation group during operation, d1 after operation and d2 after operation was lower than that in the control group, and the difference was statistically significant (P＜0.05). The cognitive function score of the observation group was higher than that of the control group, and the difference was statistically significant (P＜0.05). The occurrence rate of shiver(8.11%) during anesthesia recovery period and postoperative infection rate(4.05%) in the observation group were lower than those(27.03% and 16.22%) in the control group, and the difference was statistically significant(P＜0.05). Conclusion: General management of intraoperative temperature can effectively maintain the intra-operative normal core body temperature and the normal physiological functions of blood system and nervous system of senile patients with lung cancer, enhance their early postoperative cognitive function, and reduce the risks during perioperative period. |
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