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综合保温对宫腔镜手术患者应激反应和免疫功能的影响:一项回顾性研究。

Impact of comprehensive thermal insulation on stress response and immune function in hysteroscopy patients: A retrospective study.

作者信息

Huang Xiaoqing, Ao Yumin, Zhang Liulian, Yang Lin

机构信息

Kejiaobu, Xinyu People's Hospital, Xinyu, Jiangxi, China.

Department of Obstetrics and Gynecology, Xinyu Maternal and Child Health Hospital, Xinyu, Jiangxi, China.

出版信息

Medicine (Baltimore). 2024 Nov 22;103(47):e40309. doi: 10.1097/MD.0000000000040309.

Abstract

This retrospective study explores the impact of comprehensive thermal insulation measures on the stress response of patients undergoing hysteroscopy surgery. A total of 600 patients who underwent hysteroscopy at our hospital from January 2018 to December 2022 were included. Participants were randomly assigned to an observation group (n = 305) and a control group (n = 295). The control group received standard nursing care, whereas the observation group received additional comprehensive thermal insulation measures. We compared body temperature and stress response indicators, including heart rate, diastolic blood pressure, systolic blood pressure, blood glucose, adrenaline, norepinephrine, and C-reactive protein, at 3 time points: before surgery (T0), 30 minutes into surgery (T1), and after surgery (T2). A comparative analysis of immune competence, focusing on the variations in CD3+, CD4+, CD8+ T lymphocyte populations, and CD4+/CD8+ ratios, was conducted between the groups preoperatively and at a 24-hour postoperative juncture. The occurrence of intraoperative complications after surgery was analyzed. The central body temperature in the observation group at T1 and T2 was higher than that of the control group (P < .001). The levels of heart rate, diastolic blood pressure, systolic blood pressure, blood glucose, adrenaline, norepinephrine, and C-reactive protein in the observation group at T1 and T2 were lower than those in the control group (P < .05). The percentage of CD3+, CD4+, CD4+/CD8+ cells in the observation group at 1 day after surgery was higher than those in the control group (P < .05). The incidence of intraoperative and postoperative complications in the observation group after surgery was lower than that in the control group (P < .001). Implementing a comprehensive thermal insulation protocol for patients undergoing hysteroscopy may help maintain core temperature and support immune response following surgery, potentially contributing to a smoother recovery process. Further research is warranted to confirm these findings and better understand the implications for patient care.

摘要

这项回顾性研究探讨了综合保温措施对宫腔镜手术患者应激反应的影响。纳入了2018年1月至2022年12月在我院接受宫腔镜手术的600例患者。参与者被随机分为观察组(n = 305)和对照组(n = 295)。对照组接受标准护理,而观察组接受额外的综合保温措施。我们比较了3个时间点的体温和应激反应指标,包括心率、舒张压、收缩压、血糖、肾上腺素、去甲肾上腺素和C反应蛋白:手术前(T0)、手术30分钟时(T1)和手术后(T2)。对两组术前和术后24小时的免疫能力进行了比较分析,重点关注CD3 +、CD4 +、CD8 + T淋巴细胞群体的变化以及CD4 + / CD8 +比率。分析了手术后术中并发症的发生情况。观察组在T1和T2时的中心体温高于对照组(P <.001)。观察组在T1和T2时的心率、舒张压、收缩压、血糖、肾上腺素、去甲肾上腺素和C反应蛋白水平低于对照组(P <.05)。观察组术后1天CD3 +、CD4 +、CD4 + / CD8 +细胞的百分比高于对照组(P <.05)。观察组手术后术中及术后并发症的发生率低于对照组(P <.001)。对接受宫腔镜手术的患者实施综合保温方案可能有助于维持核心体温并支持术后免疫反应,可能有助于恢复过程更顺利。有必要进行进一步研究以证实这些发现并更好地理解其对患者护理的意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49b4/11596532/976a3383e1b9/medi-103-e40309-g001.jpg

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