基于乌司他丁的小儿先天性心脏病体外循环术后体温的护理干预

目的 探讨基于乌司他丁的小儿先天性心脏病体外循环术后体温的护理干预方法与价值。 方法 研究对象是2011年8月—2015年4月由哈尔滨医科大学附属第二医院接收并医治的76位先天性心脏病儿童,通过随机数字表法进行分组,即对照组和观察组,每组患儿均为38例,2组都给予体外循环,在此基础上观察组灌注含有乌司他丁的肺保护液,同时给予积极的护理干预。 结果 观察组术后2 h的体温(37.46±0.43)℃]与术后24 h的体温(38.28±0.56)℃]都明显高于对照组(36.12±0.48)℃、(36.78±0.46)℃,P<0.05]。观察组的呼吸机辅助时间(27.45±5.33) d]与术后住院时间(23.45±4.31) d]明显少于对照组(41.98±6.13) d、(27.93±4.09) d,P<0.05]。2组术后24 h的颈静脉血氧饱和度(jugular venous oxygen saturation,Sjv0₂)值和血清肿瘤坏死因子-α(tumor necrosis factor,TNF-α)值都明显高于术前(均P<0.05),不过观察组术后24 h的Sjv0₂值(72.48±6.09)%]和血清TNF-α值(7.98±2.14) pg/ml]明显低于对照组(84.20±5.68)%、(8.89±1.54) pg/ml,均P<0.05]。 结论 基于乌司他丁的小儿先天性心脏病体外循环术后体温的护理干预能有效抑制促炎因子的释放,降低脑氧代谢,从而有利于术后体温的保持,促进患儿的康复。 

The postoperative temperature nursing intervention for the congenital heart disease children by the cardiopulmonary bypass based on the ulinastatin

Objective To explore the postoperative temperature nursing intervention and its value based on the ulinastatin (UTI) for the congenital heart disease children by the cardiopulmonary bypass. Methods We selected 78 congenital heart disease children admitted to our hospital from August, 2011 to April, 2015 and randomly divided into the observation group and control group, with 38 patients in each group. Both groups were given cardiopulmonary bypass, on the basis of which the observation group was given the UTI infusion of lung preservation solution together with positive nursing intervention. Results The observation group 2 h postoperative body temperature(37. 46 ±0. 43)℃]and 24 h postoperative body temperature(38. 28 ±0. 56)℃] were significantly higher than that of the control group(36. 12 ±0. 48)℃, (36. 78 ±0. 46)℃], P < 0. 05. The ventilation time(27. 45 ±5. 33) d] and postoperative hospital stay(23. 45 ±4. 31) d] in the observation group were significantly less than the control group(41. 98 ±6. 13) d and (27. 93 ±4. 09) d, P < 0. 05]. The postoperative 24 h Sjv O₂ values and serum TNF-α values in the two groups were significantly higher than the preoperative (P < 0. 05), but the postoperative 24 h SjvO₂ values(72. 48 ±6. 09)%]and serum TNF-α values(7. 98 ±2. 14) pg/ml] in the observation group were significantly lower than the control group(84. 20 ±5. 68)%, (8. 89 ±1. 54) pg/ml, P < 0. 05]. Conclusion Postoperative temperature nursing intervention based on the UTI for the congenital heart disease children by the cardiopulmonary bypass can effectively inhibit the release of pro-inflammatory cytokines and reduce brain oxygen metabolism, thus it is beneficial to maintain postoperative temperature and promote the rehabilitation of children.