The Research Of Nursing Interventions And Related Factors Of Hypothermia During Operation In Patients With Percutaneous Nephrolithotomy

BackgroundWith the development of medical technology, laparoscopic surgery andminimally invasive surgery are carried out increasingly in clinical practice, and theincidence of hypothermia during operation becomes increasingly. During theoperation,there are some factors which would cause the body temperature droppedbelow normal.These factors include the inhibition on body temperature regulationcenter by anesthetics, large-area and long exposure of internal organs and limbs, largeamount of fluid.Studies have shown that the incidence of low body temperature was50%～70%during operation，and if the patients were given a lot of low-temperature liquid,5～65%of them would get a shiver. Hypothermia can affect the circulatory system,respiratory system, nervous system and can increase the incidence of postoperativecomplications which would cause larger injury to the patients. It affects the prognosis,extends the hospitalization duration, and increases the mental and economic burden ofthe patients. Even if a mild hypothermia can lead to the occurrence of manycomplications. In the recent years, with the improving of perioperative monitoringtechnology, the harm on patients of intraoperative hypothermia and the application ofthermal insulation measures have attracted wide attention.At present, Clinical workers have applied thermal insulation measures such asheated infusion device and blanket to the general surgical operation, multiple organtransplantation and neurosurgery to prevent hypothermia. Although a single insulationmethods can prevent intraoperative hypothermia, it can not entirely avoid the impactof other factors on the body temperature.Compound incubation nursing interventionscontaining several thermal insulation measure was used in this study to maintain thestability of the body temperature of patients in the surgery, and to protect thephysical function. It was studied that the compound incubation nursing intervention measures as anatural, non-invasive therapies were applied to hypothermia patients who havepercutaneous nephrolithotomy (PCNL). This method was safe, simple and easy tocarry out and can effectively prevent hypothermia and the occurrence of postoperativeshivering in the process of surgery, while reducing the incidence of complications,increasing comfort of patient and to help patients survive the operation period. Itprovides evaluation platform for the clinic to look for effective, convenient, low-costcompound incubation nursing interventions.ObjectivesOur study was to analyzed relatively the factors of hypothermia in the surgeryand postoperative shivering occurrence by monitoring the patients of PCNL. It wasevaluated that compound incubation nursing interventions affects body temperature inpatients of PCNL to explore a safe, simple, reliable, and effective treatment tomaintain the stability of body temperature and increase patient comfort in patientsundergoing surgery. The clinical value of the compound incubation nursinginterventions used in PCNL was investigated and the increase of the safety of patientsin or after surgery and prognosis improvement were explored to clarify the clinicalsignificance of the compound incubation of nursing interventions.Methods(1) To compare the general situation of patients in control and observationgroups, statistical examination was used to analyzed the temperature changes inpreoperative and postoperative patients of two groups.(2) To compare the temperature changes in preoperative, intraoperative andpostoperative patients of control groups and experimental groups, repeatedmeasurements analysis of variance was used to evaluate the effection of compoundincubation nursing interventions on body temperature.(3) To compare postoperative shivering occurrence of in patients of controlgroups and experimental groups, χ2test was used to further illustrated the affection ofcompound incubation nursing interventions on loss of temperature in patients duringsurgery.Results(1) There is no significant difference in gender, age, weight, operative time, fluidVolume and perfusion volume(P>0.05), indicating that the affection on body temperature in preoperative, and postoperative patients of the two groups was similar.(2) Though comparing the temperature changes in preoperative, intraoperativeand postoperative patients of control groups and experimental groups, statisticalanalysis showed that:1） Temperature values compare within groups: bodytemperature in postoperative patients drops significantly (F=319.918, P<0.001)compared to preoperative, intraoperative patients of control groups for the time factor;There was statistically significant difference(F=105.332, P<0.001) when bodytemperature in preoperative, intraoperative and postoperative patients were comparedin experimental groups with the interaction of intervention factors and time, indicatingthat there is difference in the patient’s body temperature whether to take interventionswith different operation time.2）Temperature values compare between groups:There was significant difference that body temperature at30,60,90,120min after thestart of surgery and different time after surgery was compared between control andexperimental groups, indicating that body temperature of the patients who takeadvantage of compound incubation nursing interventions in experimental groups didnot change obviously, while body temperature in control patients drops significantly.(3) The comparison of the occurrence of postoperative shivering betweenexperimental and control groups: postoperative shivering incidence in patients ofexperimental group is far lower than the control groups. There is significant statisticaldifference between control and experimental patients of the postoperative shiveringincidence（χ2=9.650，P=0.002）, further indicating that compound incubation nursinginterventions can inhibit in PCNL patients.(4) To establish an effective nursing intervention for inhibiting hypothermiaduring operation and postoperative shivering in PCNL patients.(5) It was easy to carried out the application of nursing intervention inhypothermia during operation in PCNL patients, which can prevent patients fromhypothermia during operation and postoperative shivering effectively and increasenursing quality of the operation rooms.Conclusion(1) Indicating that the application of compound incubation nursing interventions in PCNL patients may inhibit the occurrence of hypothermia and postoperativeshivering.(2) The application of compound incubation nursing interventions in PCNLpatients can maintain normal temperature and prevent hypothermia during operationeffectively to enable the patients spent operative period steadily.