手术室术中保温干预对老年股骨骨折患者出血量、体温及术后凝血功能的影响

目的 探讨手术室术中保温干预老年股骨骨折患者出血量、体温及术后凝血功能的影响.方法 选取2013年5月至2015年1月我院收治的老年股骨骨折患者80例为研究对象,随机分为观察组和对照组各40例,对照组给予常规护理干预,观察组在对照组基础上给予保温干预,比较两组干预前后出血量、体温等围术期指标,分析其干预前后活化部分凝血活酶时间(aPTT)、凝血酶原时间(PT)、纤维蛋白原(Fbg)、凝血酶时间(TT)水平,同时应用功能独立性评定量表(FIM)、护理满意度评分表、简化McGill疼痛量表评价其股骨功能恢复情况、护理满意度及疼痛度,并记录术后并发症.结果 干预后观察组出血量低于对照组(P＜0.05),观察组体温较对照组升高(P＜0.05);观察组干预后aPTT、PT、Fbg、TT水平与干预前比较无明显变化(P＞0.05),对照组aPTT、PT、TT明显缩短(P＜0.05),Fbg升高(P＜0.05);观察组FIM、护理满意度评分高于对照组(P＜0.05),观察组McGill评分低于对照组(P＜0.05);观察组并发症发生率5.00％低于对照组20.00％ (P ＜0.05).结论 手术室保温干预可明显降低老年股骨骨折患者出血量,改善体温,减少手术对患者凝血功能的影响,降低术后并发症.

Effects of Intraoperative heat Preservation Intervention in Operating room on Blood loss,body Temperature and Postoperative Coagulation Function of Elderly Patients with Femoral Fracture

Objective To explore effects of intraoperative heat preservation intervention in operating room on blood loss,body temperature and postoperative coagulation function of elderly patients with femoral fracture.Methods 80 elderly patients with femoral fracture treated in our hospital from May 2013 to January 2015 were selected as the research objects,they were divided by random number table into the observation group and the control group (each 40 cases),the control group was given routine nursing intervention,the observation group added heat preservation intervention on the basis of the control group,blood loss,body temperature and other perioperative indexes between the two groups before and after the intervention were compared,activated partial thromboplastin time (aPTT),prothrombin time (PT),fibrinogen (Fbg),thrombin time (TT)level before and after the intervention were analyzed,functional independence measure (FIM),nursing satisfaction score,simplified McGill pain questionnaire were used to evaluate recovery of femoral function,nursing satisfaction and pain degree,and postoperative complications were recorded.Results Blood loss in the observation group after the intervention was significantly lower than the control group(P ＜ 0.05),body temperature in the observation group was significantly increased than the control group(P ＜ 0.05);there was no significant changes in aPTT,PT,Fbg,TT level before and after the intervention in the observation group (P ＞ 0.05),aPTT,PT,TT in the control group were significantly decreased (P ＜ 0.05),Fbg was increased (P ＜0.05);FIM score score,nursing satisfaction score in the observation group were higher than the control group(P ＜ 0.05),McGill score score in the observation group was lower than the control group(P ＜ 0.05);complication rate of the observation group 5.00％ was significantly lower than the control group(20.00％)(P ＜ 0.05).Conclusion Heat preservation intervention in operating room can significantly reduce blood loss of elderly patients with femoral fracture,improve body temperature,reduce effects of surgery on patients' coagulation function,reduce postoperative complications.