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术后保暖护理方案对手术即刻后热舒适和体温管理的评估:非随机对照试验。

Evaluation of Postoperative Warming Care Protocol for Thermal Comfort and Temperature Management Immediately After Surgery: Nonrandomized Controlled Trial.

机构信息

Fundamentals and Biobehavioral Nursing, Graduate School of Nursing Sciences, St. Luke's International University, Chuo-ku, Tokyo, Japan.

Frontier Practice Nursing, Graduate School of Nursing, Chiba University, Chiba City, Chiba, Japan.

出版信息

J Perianesth Nurs. 2023 Jun;38(3):427-433. doi: 10.1016/j.jopan.2022.07.001. Epub 2023 Jan 5.

Abstract

PURPOSE

This study aimed to determine the effects of a warming care protocol (WCM) on temperature control and thermal comfort perception in hypothermia following major abdominal surgery.

DESIGN

A prospective nonrandomized controlled trial.

METHODS

A total of 54 patients undergoing major abdominal surgery were assigned to receive routine care (control group, 27 patients) or the WCM (intervention group, 27 patients). The body temperature (core and peripheral) was measured, and physical symptoms were monitored every hour for 4 hours after arriving at the ward and then every 4 hours for up to 12 hours.

FINDINGS

The temperature gap, calculated as the difference between the core and skin temperatures, was similar between the control and intervention groups at the end of surgery. However, the temperature gap in the intervention group decreased within 3 hours after arrival at the ward and remained lower than that in the control group. The visual analog scale score for postoperative thermal discomfort was significantly lower in the intervention group than in the control group, indicating achievement of higher comfort with the warming intervention.

CONCLUSIONS

Patients were warmed using active warming methods under the WCM, which in turn increased the thermal comfort perception with the body temperature. Postoperative patients often require warming care for thermal comfort, which may be improved by proper observation and management within 1 to 2 hours postoperatively. Our results indicate that nurses could effectively warm the patient to maintain normal body temperature following surgery not only to improve thermal comfort, but also to prevent shivering and possibly various postoperative complications.

摘要

目的

本研究旨在确定保暖护理方案(WCM)对大型腹部手术后低体温患者体温控制和热舒适度感知的影响。

设计

前瞻性非随机对照试验。

方法

共有 54 例行大型腹部手术的患者被分为接受常规护理(对照组,27 例)或 WCM(干预组,27 例)。在到达病房后每小时测量一次体温(核心和外周),并监测身体症状 4 小时,然后每 4 小时监测一次,持续 12 小时。

结果

手术结束时,两组之间的体温差距(核心温度与皮肤温度之间的差异)相似。然而,干预组的体温差距在到达病房后 3 小时内下降,并保持低于对照组。干预组术后热不适的视觉模拟评分明显低于对照组,表明保暖干预的舒适度更高。

结论

患者在 WCM 下使用主动保暖方法进行保暖,这反过来又提高了体温的热舒适度感知。术后患者通常需要保暖护理以获得热舒适度,通过术后 1 至 2 小时内的适当观察和管理,可以改善这种舒适度。我们的结果表明,护士可以有效地为患者保暖,以维持手术后的正常体温,不仅可以提高热舒适度,还可以预防寒战和可能出现的各种术后并发症。

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