刘畅　刘秋秋

[摘要]目的 探討复合保温措施预防前列腺电切老年患者术中低体温的效果。方法 选取我院2019年2～10月收治的68例年龄>70岁的实施前列腺电切手术的前列腺增生老年患者作为研究对象，按照配对原则随机分为对照组（34例）和观察组（34例）。对照组采用常规保温措施，观察组采用复合保温措施。比较两组患者不同时刻的鼻咽温度（T1为入室时体温，T2为经麻醉诱导后，T3为术中30 min，T4为术中60 min，T5为术毕体温），观察记录两组的术中出血量、麻醉复苏时间、低体温发生率。结果 两组T1、T2、T3的体温比较，差异无统计学意义（P>0.05）;观察组T4、T5的体温高于对照组，差异有统计学意义（P<0.05）。观察组T2、T3、T4的体温与T1比较，差异无统计学意义（P>0.05）;观察组T5的体温明显低于T1，差异有统计学意义（P<0.05）。对照组T2与T1的体温比较，差异无统计学意义（P>0.05）;对照组T3、T4、T5的体温明显低于T1，差异有统计学意义（P<0.05）。观察组的低体温发生率明显低于对照组，差异有统计学意义（P<0.05）。观察组的术中出血量少于对照组，麻醉恢复时间短于对照组，差异有统计学意义（P<0.05）。结论 对于前列腺电切术老年患者，采用复合保温护理措施的效果显著，可有效维持患者术中正常体温，预防低体温的发生，值得优选。

[关键词]复合保温;老年;经尿道前列腺电切术;低体温

[中图分类号] R697+.32          [文献标识码] A          [文章编号] 1674-4721（2020）6（c）-0242-04

Effect of compound heat preservation measures on prevention of hypothermia in elderly patients undergoing electroprostatectomy

LIU Chang   LIU Qiu-qiu

Department of Urology， Xiangya Hospital of Central South University， Hu′nan Province， Changsha   410008， China

[Abstract] Objective To investigate the effect of combined heat preservation measures on preventing hypothermia in elderly patients undergoing electroprostatectomy. Methods From February to October 2019， 68 elderly patients over 70 years old with benign prostatic hyperplasia （BPH） who underwent electroprostatectomy patients were selected as the research objects， and they were randomly divided into the control group （34 cases） and the observation group （34 cases） according to the matching principle. The control group adopted the conventional thermal insulation measures， and the observation group adopted the composite thermal insulation measures. The nasopharynx temperature at different times （T1 was the temperature when entering the room， T2 was the temperature after anesthesia induction， T3 was the temperature during the operation for 30 minutes， T4 was the temperature during the operation for 60 minutes， and T5 was the temperature after the operation） was compared between the two groups， and the amount of bleeding during the operation， the time of anesthesia recovery， and the incidence of hypothermia of the two groups were observed and recorded. Results There was no significant difference in the body temperature of T1， T2 and T3 between the two groups （P>0.05）. The body temperature of T4 and T5 in the observation group was higher than that of the control group， the difference were statistically significant （P<0.05）. The temperature of T2， T3 and T4 in the observation group was significantly lower than that of T1， the difference were statistically significant （P<0.05）. There was no significant difference in the body temperature between T2 and T1 in the control group （P>0.05）. The body temperature of T3， T4 and T5 in the control group was significantly lower than that of T1， the difference were statistically significant （P<0.05）. The incidence of hypothermia in the observation group was significantly lower than that in the control group， the difference was statistically significant （P<0.05）.The amount of bleeding in the observation group was less than that in the control group， and the recovery time of anesthesia in the observation group was shorter than that in the control group， the difference were statistically significant （P<0.05）. Conclusion In the elderly patients with electroprostatectomy， the effect of application of composite heat preservation nursing measures is significant， which can effectively maintain the normal temperature of patients during the operation， prevent the occurrence of hypothermia， it is worth optimizing.

[Key words] Compound heat preservation; Elderly; Electroprostatectomy; Hypothermia

前列腺增生是我国老年男性的常见病和多发病，经尿道前列腺电切手术（transurethral resection of prostate，TURP）为最常用、最有效的治疗方法，其为经自然腔道进行手术，具有无手术伤口、无瘢痕、创伤小、痛苦少、术后康复快等特点。但由于老年患者体质代谢减慢，体温调节能力下降，TURP中大量的冲洗液等风险因素极易导致术中低体温。研究报道，围术期患者术中低体温的发生率可达到50%～70%[1-2]。若低体温不及时处理，可能会使患者凝血功能异常、增加失血量、术后麻醉恢复时間延长、寒战、免疫力降低引起术后感染等不良事件[3]。因此，为降低不良事件的发生，本研究以行TURP老年患者为例，应用复合保温措施，探讨其效果。