作者单位：252000聊城市山东省聊城市人民医院西区手术室

付庆华:女，本科，主管护师

大量加温生理盐水冲洗液对消化道穿孔患者的影响

付庆华

摘要目的：探讨大量加温生理盐水冲洗液对消化道穿孔修补术患者的冲洗效果。方法：将60例患者随机等分为试验组和对照组，对照组患者术中使用室温放置的生理盐水进行腹腔冲洗和肠管灌洗，试验组患者术中使用加温生理盐水进行污染腹腔冲洗，比较两组患者冲洗前后体温、心率变化和切口感染、寒战发生率。结果:试验组患者手术过程中体温高于对照组(P<0.05),心率与寒战发生率、术后切口感染发生率均低于对照组(P<0.05)。结论：采用大量加温生理盐水对严重污染的腹腔进行冲洗，可减轻手术患者低体温的发生，避免由于低体温而引起的各种并发症的发生，减轻患者的痛苦，保证患者舒适。

关键词生理盐水；消化道穿孔；效果观察doi:10.3969/j.issn.1672-9676.2015.02.004

收稿日期：(2014-04-16)

The influence of lots of warm saline on patients with gastrointestinal perforation.

FU Qing-hua(Liaocheng People′s Hospital,Liaocheng252000)

AbstractObjective:To investigate the washing effect of the large number of warm saline for patients with gastrointestinal perforation repair.Methods:60 patients were randomly divided into the experimental group and the control group(30 cases in each group).The patients in control group received abdominal cavity flushing and intestinal canal irrigation with room temperature saline placed in the operation.The patients in experimental group was adopted to wash abdominal flush pollution with the heating physiological saline.And the patient's temperature fluctuations was compared between the two groups.Results:The experimental group during surgerys had no significant changes in body temperature,and the vital signs were relatively stable compared with the control group.In experimental group,the patient's temperature had no obvious change during the process of operation and relative stable vital signs.And compared with the experimental group the heart rate of the control group increased fast and the control group had a hypothermia after abdominal cavity flushed.And the incidence and the incidence of postoperative incision infection in patients with postoperative shivering was higher than the experimental group.Conclusion:Serious pollution of the abdominal cavity was washed by a large amount of heat saline,it can reduce the occurrence of hypothermia for patients,which avoids various complicationscaused by the low temperature,to ease the patient′s pain,provide safe and comfotable for patients.

Key wordsWarm saline;Gastrointestinal perforation;Effect concept.

消化道穿孔是外科常见疾病，穿孔后大量污染液体流入腹腔，为了避免腹腔和手术切口感染以及减轻肠管的张力，需要应用大量生理盐水(5000~10 000 ml)长时间对腹腔进行冲洗和肠管灌洗。临床上多采用室温下放置的生理盐水进行腹腔冲洗及肠管灌洗，其温度和人体温度相差很大，大量冷冲洗液进入人体可引起患者生理变化，使患者低体温及寒战发生率提高，而腹部手术的患者围手术期低体温的发生率高于其他手术部位[1]，并且肠道手术患者外科手术部位感染发生率与低体温有关[2]。我院对60例消化道穿孔修补急症患者术中采用不同温度的生理盐水进行腹腔冲洗，观察患者术中生命体征的变化情况及手术后切口感染发生率，来探讨手术大量保温盐水冲洗的有效性及可行性，现将结果报道如下。……