保温护理对人工髋关节置换术后凝血功能的影响

目的研究保温护理对人工髋关节置换术后凝血功能的影响及低体温、寒战的预防效果。方法选取我院2013年9月至2015年9月将行人工髋关节置换术的患者90例,随机分为观察组与对照组2组,每组45例,对照组患者给予常规护理,观察组患者在对照组护理基础上给予保温护理。比较两组患者手术前后凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(a PTT)、纤维蛋白原(Fbg)等凝血功能指标变化及C反应蛋白(CRP)、肾上腺素(AD)、去甲肾上腺素(NE)等应激指标水平变化情况,比较两组患者术后寒战程度及低体温发生率。结果观察组患者术后PT、TT、a PTT、Fbg等指标较对照组显著较低(P0.05);观察组患者术后CRP、AD、NE等应激指标水平较对照组显著较低;观察组寒战的发生率为15.56%较对照组57.78%显著较低(P0.05),低体温发生率为11.11%较对照组44.44%显著较低(P0.05)。结论全髋关节置换术后给予患者保温护理能保护患者凝血功能,减轻手术应激反应,降低患者寒战、低体温的发生率。

Effect of Heat-preservation Nursing on Blood Coagulation Function After Artificial Hip Replacement and the Effects in Prevention of Hypothermia and Shivering

Objective To study the effect of heat-preservation nursing on blood coagulation function after artificial hip replacement and the effects in prevention of hypothermia and shivering.Methods 90 cases of patients who underwent artificial hip replacement in our hospital from September 2010 to September 2012 were selected and randomized into observation group and control group with 45 cases in each group.Patients in control group were given routine nursing while patients in observation group were given heat-preservation nursing,based on the control group.The changes of coagulation function indexes [prothrombin time (PT),thrombin time (TT),activated partial thromboplastin time (aPTT),fibrinogen (Fbg)] and stress indexes [C reactive protein (CRP),adrenaline (AD),norepinephrine (NE)] before and after operation were compared between the two groups.Results In the observation group the postoperative coagulation function indexes PT,TT,aPTT,Fbg were significantly lower than those in the control group (P ＜ 0.05);The levels of postoperative stress indexes CRP,AD,NE in the observation group were significantly lower than those in the control group (P ＜ 0.05) and the incidence of hypothermia (11.11％) was also significantly lower than that in the control group(44.44％) (P ＜ 0.05).Conclusion The application of heat-preservation nursing in patients after artificial hip replacement can protect the coagulation function,reduce the stress response to operation,reduce the incidence rate of shivering and hypothermia.