Changzheng Hospital, Affiliated to Naval Military Medical University, Shanghai, China.
BMC Surg. 2022 Jan 8;22(1):8. doi: 10.1186/s12893-021-01463-1.
Spinal tumor surgery usually involved long operation time, large area of soft tissue resection and long wound, and was prone to hypothermia during the operation. Therefore, actively promoting insulation and optimizing the intraoperative insulation program have great potential in reducing the incidence of hypothermia and reducing the incidence of postoperative complications. In this study, we compared patients who did not implement multi-mode nursing insulation program (MNIP) with those who implemented MNIP, observing and comparing clinical outcomes, and complications in both groups, with the aim of developing an optimal management plan for the preoperative, intraoperative, and postoperative periods, respectively.
We selected 2 periods of 1 year, before (n = 120 patients) and after MINP implementation (n = 120 patients). Data were collected on patient demographics, operative, perioperative details, temperature changes, anesthesia recovery effect, incidence of postoperative wound infection, length of hospital stay and complications. PS analyses were used for dealing with confounding bias in this retrospective observational study.
After PS matching, the outcomes of 120 well-balanced pairs of patients were compared (No-MNIP vs MNIP). There was no significant difference concerning the satisfaction survey. The results indicated that the MNIP had better insulation effect at 90 min, 120 min, 150 min after anesthesia induction and after surgery. There were 16 cases of complications in the No-MNIP group and 5 cases in the MNIP group postoperative, which have significant statistical difference.
In this study, the incidence of intraoperative hypothermia was effectively reduced by adopting the multi-mode insulation scheme, thus reducing the incidence of incision infection and shortening the length of hospital stay of patients.
脊柱肿瘤手术通常需要较长的手术时间、大面积的软组织切除和较长的切口，术中易发生低体温。因此，积极采取保温措施并优化术中保温方案，对于降低低体温发生率、减少术后并发症的发生具有较大潜力。本研究将未实施多模式护理保温方案（MNIP）的患者与实施 MNIP 的患者进行比较，观察并比较两组的临床转归和并发症，以期分别为围手术期制定最佳的管理方案。
我们选择了两个 1 年的时间段，在 MNIP 实施前（n=120 例患者）和实施后（n=120 例患者）进行。收集患者的人口统计学、手术、围手术期详细资料、体温变化、麻醉恢复效果、术后伤口感染发生率、住院时间和并发症。PS 分析用于处理本回顾性观察研究中的混杂偏差。
经过 PS 匹配后，比较了 120 对平衡良好的患者的结果（无-MNIP 与 MNIP）。满意度调查没有显著差异。结果表明，MNIP 在麻醉诱导后 90min、120min、150min 及手术后的保温效果更好。无-MNIP 组有 16 例并发症，MNIP 组有 5 例，差异有统计学意义。
本研究通过采用多模式保温方案，有效降低了术中低体温的发生率，降低了切口感染的发生率，缩短了患者的住院时间。
