胡庆圆+张成作

[摘要] 目的 考察保温护理对麻醉患者术后应激反应及并发症的影響。 方法 选择2014年1月～2015年1月在北京同仁医院进行全麻手术患者80例，按照随机数字表法随机分为对照组和试验组，每组40例。对照组患者术中接受常规护理，试验组患者接受保温护理。分别评估两组患者入室和出室时的麻醉恢复评分，记录患者苏醒期躁动发生情况，测定两组患者术后去甲肾上腺素、肾上腺素和C反应蛋白水平，记录两组患者术后出现并发症的人数。 结果 出室时两组患者麻醉恢复评分的总分和各个维度得分均比入室时显著升高（P < 0.05），其中试验组患者总分、血压和血氧饱和度维度得分显著高于对照组患者（P < 0.05）。试验组患者去甲肾上腺素、肾上腺素和C反应蛋白水平均显著低于对照组患者（P < 0.05）。试验组患者低体温和寒战的发生率显著低于对照组患者（P < 0.05）。 结论 保温护理可以帮助降低全麻苏醒期的应激反应，使患者苏醒过程更加平稳，有效避免苏醒期躁动，值得临床推广。

[关键词] 保温护理；麻醉恢复评分；应激反应

[中图分类号] R473.6 [文献标识码] A [文章编号] 1673-7210（2017）01（a）-0173-04

[Abstract] Objective To investigate the effect of heat preservation on stress reaction and complication of anesthesia patients. Methods From January 2014 to January 2015， 80 patients in Beijing Tongren Hospital were selected and divided into control group and experimental group by random number table method， with 40 cases in each group. Patients in the control group received routine nursing， and patients in the experimental group received heat preservation nursing. The anesthesia recovery scores of patients in the two groups when entering room and out of the room were evaluated. The restlessness during recovery was recorded. The levels of norepinephrine， epinephrine and C-reactive protein in the two groups were measured and the number of postoperative complications of patients in the two groups was recorded. Results The total score and each dimension scores of patients in the two groups were significantly increased when they got out of the room （P < 0.05）. The total score and scores of blood pressure and SpO2 in the experimental group were significantly higher than those in the control group （P < 0.05）. The levels of norepinephrine， epinephrine and C-reactive protein in the experimental group were significantly lower than those in the control group （P < 0.05）. The incidence rate of the experimental group of patients with hypothermia and shivering was lower than that of control group （P < 0.05）. Conclusion Heat preservation nursing can help reduce the stress response during the recovery period of general anesthesia， so that the patient's recovery process is more stable. It can effectively avoid the agitation. It is worthy of clinical promotion.

[Key words] Heat preservation nursing； Anesthesia recovery score； Stress reaction

随着现代医疗科技的发展，很多大型手术的操作均需要对患者进行全身麻醉[1-2]。检测患者麻醉后的生命体征十分重要。其中，全麻后的低体温是常见并发症之一，它容易引起患者在麻醉苏醒期出现应激反应，从而导致患者出现内分泌紊乱，进而增加苏醒期躁动的发生率[3-6]。因此在患者全麻过程中进行合理保温护理，预防出现低体温十分必要。本研究旨在探讨保温护理联合麻醉恢复评分对麻醉患者术后应激反应及并发症的影响，为临床全麻手术护理方式的选择提供理论依据。

1 资料与方法

1.1 一般资料

選择2014年1月～2015年1月在北京同仁医院治疗的心脏手术患者，按照严格的纳入标准和排除标准进行筛选后得到符合标准的临床资料80例，按照随机数字表法分为对照组和试验组，每组各40例。……