足部穴位热熨对肿瘤患者全麻术后低体温恢复的干预研究

目的近年来,中医干预低体温取得一定进展。足部穴位丰富,是中医外治常选机体部位,本研究分析足部穴位热熨对肿瘤患者全麻术后低体温的影响,为今后术后低体温干预提供参考。方法采用前瞻性研究,根据本研究相关标准将2016年1月—2017年6月浙江中医药大学附属第二医院肿瘤外科收治全麻手术患者纳入研究(80例),采用抽签的方式随机分为2组,对照组行室温控制、加盖被褥等常规护理,观察组在其基础制作艾盐包,经恒温箱加热后用小毛巾包裹,在涌泉穴、冲阳穴分别热熨20 min,记录术前及返回病房时体温、足背温度,记录体温、足部皮肤恢复至基础体温所用时间及寒战消退时间、患者主观寒冷感消退时间;评估2组寒战发生程度,调查护理满意度。结果 2组患者术前及返回病房时体温、足背部皮肤温度差异均无统计学意义(均P>0.05);观察组体温、足背部温度恢复到基础体温所用时间较对照组短(均P<0.001);观察组寒战消退时间、主观寒冷感消退消失时间均较对照组短(均P<0.001);观察组3级寒战发生率为15.00%,较对照组(30.00%)低(χ~2=2.581,P=0.108),2组寒战总发生率和三级寒战发生率比较差异无统计学意义(均P>0.05);护理满意率(90.00%)较对照组(72.50%)高,差异有统计学意义(χ~2=4.021,P=0.045)。结论足部穴位热熨护理能促进肿瘤患者全麻术后低体温复常,尽快消除寒战及低体温带给患者的不适感,减少严重寒战的发生,提高护理满意度。

Study on the intervention of hot point of foot acupuncture on hypothermia recovery after general anesthesia in patients with cancer

Objective In recent years, some progress has been made in the intervention of traditional Chinese medicine on hypothermia. Foot points are abundant, which is a common body part for external treatment of traditional Chinese medicine. This study analyzed the effect of foot heat ironing on hypothermia in patients with tumor after general anesthesia, thus to provide reference for postoperative hypothermia intervention. Methods According to the relevant criteria of this study, 80 patients with general anesthesia in our hospital were randomly divided into two groups by drawing lots, and the control group was controlled by room temperature. Routine nursing care, such as covering bedding and so on, was used in the observation group. After heating in the incubator, the observation group was wrapped with a small towel and ironed for 20 minutes at the points of Yongquan and Chongyang respectively. The temperature of the patients before operation and returning to the ward was recorded, and the temperature of the foot back was recorded, and the temperature of the foot was recorded, as well as the recovery time of foot skin to basic body temperature and the time of shivering retreat, the time of subjective cold feeling regression, the evaluation of the degree of shivering in the two groups, and the investigation of nursing satisfaction. Results There was no significant difference in body temperature and skin temperature between the two groups before operation and back to ward (all P>0.05), the time to recover back temperature to basic body temperature in the observation group was shorter than that in the control group (all P<0.001), and the time of shivering subsiding in the observation group was less than that in the control group. The disappearance time of subjective cold feeling was shorter than that of the control group (all P<0.001), the rate of shivering in the observation group was 15.00%, which was lower than 30.00% in the control group (χ2=2.581, P=0.108), and the nursing satisfaction rate (90.00%) was higher than (72.50%) in the control group (χ2=4.021, P=0.045). Conclusion The nursing care of foot hot ironing can promote hypothermia of tumor patients after general anesthesia, eliminate the discomfort caused by shivering and hypothermia as soon as possible, reduce the occurrence of severe shivering, and improve nursing satisfaction.