目的 探究手术室保温护理对剖宫产产妇术中低体温及术后寒战的预防效果。方法 选择2019年6月—2020年7月开展剖宫产产妇310例为研究对象,根据随机数字表法将其分为对照组155例与观察组155例,对照组采取常规护理措施,观察组采取手术室保温护理。比较两组产妇入手术室时、手术10 min、术毕体温,记录术中低体温、术后寒战发生人数,评价寒战严重程度,术后次日采用问卷调查产妇满意度。结果 观察组手术10 min体温、术毕室温均高于对照组,分别为（36.62±0.39） ℃对（35.91±0.43） ℃、（36.27±0.38） ℃对（35.63±0.42） ℃,差异有统计学意义（P<0.05）;观察组术中低体温发生率低于对照组（1.29%对9.68%）,术后寒战发生率低于对照组（3.23%对46.45%）,寒战严重程度轻于对照组,差异有统计学意义（P<0.05）;观察组产妇满意度高于对照组（93.55%对70.32%）,差异有统计学意义（P<0.05）。结论 手术室保温护理在剖宫产术中应用可降低术中低体温及术后寒战发生率,提升产妇满意度。
Objective To explore the preventive effect of thermal insulation nursing on intraoperative hypothermia and postoperative shivering of cesarean section. Methods A total of 310 cases of cesarean delivery women from June 2019 to July 2020 were selected as study subjects. According to random number table, they were divided into a control group （155 cases）, who received traditional nursing measures, and an observation group （155 cases）, who received thermal insulation nursing in operation rooms. The body temperature of the two groups of pregnant women was compared at the time of entering operating room, 10 min of operation, and after operation. Intraoperative hypothermia and postoperative shivering cases were recorded, and the severity of shivering was evaluated. On the day after operation, the satisfaction of nursing among the pregnant women was investigated by questionnaire. Results The observation group showed higher body temperature than the control group at 10 min of operation [（36.62±0.39） ℃ vs. （35.91±0.43） ℃], and after operation [（36.27±0.38） ℃ vs. （35.63±0.42） ℃], with significant differences （P<0.05）. The incidence rates of intraoperative hypothermia （1.29% vs. 9.68%） and postoperative shivering （3.23% vs. 46.45%） in the observation group were lower than those in the control group, and shivering of the observation group was less severe than that of the control group, with significant difference （P<0.05）. The pregnant women in the observation group showed higher satisfaction of nursing than the control group （93.55% vs. 70.32%）, and the difference was statistically significant （P<0.05）. Conclusion The application of thermal insulation nursing during cesarean section can reduce the incidence of intraoperative hypothermia and postoperative shivering and improve satisfaction of nursing among pregnant women.
[1] 林曼,许莉,王秀妹,等.海口市10年间巨大儿发生率、剖宫产率和孕妇要求剖宫产率的变化及剖宫产指征分布[J].中国卫生统计,2019,36(6):889-892.
[2] 李亮. 剖宫产术中低体温的危害及预防措施[J].实用妇科内分泌电子杂志,2019,6(34):155-156.
[3] 张东宁. 积极保暖干预对剖宫产所致手术源性低体温的影响[J].解放军护理杂志,2018,35(21):45-49.
[4] 朱佳,张琼.手术室术中患者低体温因素分析与复合保温措施效果观察[J].护理实践与研究,2020,17(1):122-124.
[5] 马国岭. 腹腔镜全子宫切除术中低体温发生状况及影响因素分析[J].中国妇幼保健,2020,35(15):2777-2779.
[6] 曹伟新,李乐之.外科护理学[M].北京:人民卫生出版社,2007:54.
[7] Wrench I J,Singh P,Dennis A R,et al.The minimum effective dosesof pethidine and doxapram in the treatment of postanaesthetic shivering[J]. Anaesthesia,1997,52(1):32-36.
[8] 冷蔚蔚,周素玲,张维峰,等.水循环保温毯用于联合麻醉下剖宫产手术的效果观察[J].护理学报,2014,21(12):42-44.
[9] 吴文莉,张连发,曾菊花,等.术中积极保暖护理对产妇剖宫产术后低体温现象和体核温度的影响[J].白求恩医学杂志,2020,18(2):117-119.
[10] 张晨,陈利海,孙蓓,等.右美托咪定对剖宫产围术期体温及并发寒颤的影响[J].临床麻醉学杂志,2019,35(10):973-976.
[11] 李迎春,段燕,杨利,等.不同保温措施对剖宫产产妇术中低体温预防效果的系统评价[J].循证护理,2018,4(6):488-495.
[12] 徐莉莉,卢中秋,林卫红.手术室积极保暖干预措施对剖宫产术后手术源性低体温的影响[J].中国实用护理杂志,2018,34(25):1942-1946.
