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保温对钬激光碎石术患者康复和舒适度的影响。

Effects of Thermal Insulation on Recovery and Comfort of Patients Undergoing Holmium Laser Lithotripsy.

机构信息

Department of Operating Room, Xiamen University, Xiamen, Fujian, China (mainland).

出版信息

Med Sci Monit. 2024 Apr 18;30:e942836. doi: 10.12659/MSM.942836.

Abstract

BACKGROUND Patients with urolithiasis often undergo transurethral ureteroscopic holmium laser lithotripsy, a procedure that can be affected by perioperative thermal management. This study examines the impact of compound thermal insulation management on patient recovery and comfort during transurethral ureteroscopic holmium laser lithotripsy. MATERIAL AND METHODS In this study, 551 patients who underwent transurethral ureteroscopic holmium laser lithotripsy from April 2019 to December 2022 were randomly assigned to either an observation group (n=276) or control group (n=275). Both groups received routine surgical care, with the observation group additionally receiving compound thermal insulation management. We recorded and compared perioperative body temperature changes, anesthetic resuscitation indicators (bispectral index recovery time, extubation time, fully awake time, Postanesthesia Care Unit retention time), comfort level (General Comfort Questionnaire), and quality of life (Nottingham Health Profile). We also compared the incidence of complications. RESULTS There was no significant difference in body temperature between groups at the start surgery. However, the observation group showed significantly higher temperatures during and at the end of surgery. Anesthetic resuscitation indicators were significantly better in the observation group. Both groups showed improved comfort and quality of life after surgery, with more significant improvements in the observation group. The observation group also had a lower incidence of complications, such as hypothermia and rigor. CONCLUSIONS Compound thermal insulation management during transurethral ureteroscopic holmium laser lithotripsy improved perioperative temperature maintenance, accelerated postoperative recovery, reduced complication rates, and enhanced patient comfort and quality of life.

摘要

背景

尿路结石患者常需行经尿道输尿管镜钬激光碎石术,该手术过程易受围手术期热管理的影响。本研究旨在探讨复合保温管理对经尿道输尿管镜钬激光碎石术患者术后恢复和舒适度的影响。

材料与方法

本研究纳入了 2019 年 4 月至 2022 年 12 月期间接受经尿道输尿管镜钬激光碎石术的 551 例患者,将其随机分为观察组(n=276)和对照组(n=275)。两组均接受常规手术护理,观察组在此基础上联合复合保温管理。记录并比较两组患者围手术期体温变化、麻醉复苏指标(脑电双频指数恢复时间、拔管时间、完全清醒时间、术后恢复室停留时间)、舒适度(一般舒适度问卷)和生活质量(诺丁汉健康问卷),并比较并发症发生率。

结果

两组患者手术开始时体温无显著差异,但观察组术中及术毕时体温显著升高。观察组麻醉复苏指标显著改善。两组患者术后舒适度和生活质量均有改善,观察组改善更显著。观察组并发症发生率较低,如低体温和肌强直。

结论

经尿道输尿管镜钬激光碎石术中采用复合保温管理可改善围手术期体温维持,加速术后恢复,降低并发症发生率,提高患者舒适度和生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0c9/11036894/0ccf93ed241b/medscimonit-30-e942836-g001.jpg

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