保溫措施對腹部手術患者體溫及麻醉恢復之影響

The Effects of Rewarming Strategy on Patients Receiving Abdominal Surgery during Intraoperative Phase in Prevention Core Hypothermia and Postanesthetic Recovery

本研究之目的為比較手術中有無使用體溫調節儀對手術中期腹部手術患者體溫及麻醉恢復之成效探討。本研究採類實驗法，以立意取樣選樣方法，將樣本分成控制組35人與實驗組35人，對象來自二所北區教學醫院接受腹部手術患者。實驗組在手術中介入保溫措施一體溫調節儀，控制組則採常規保溫處理。研究工具包括基本資料、手術當中的處理、手術期間生理監測表、麻醉恢復評估表等。研究結果顯示實驗組比控制組在手術結束時之核心體溫高，控制組平均核心體溫為35.83°C(SD=0.57)，屬於輕度低體溫；實驗組平均核心體溫為36.41°C(SD=0.58)，屬於正常體溫。實驗組比控制組達理想麻醉恢復狀態及體溫至36°C所需時間平均提早41.29分鐘，統計達顯著差異。本研究結果指出手術室護理人員提供體溫調節儀做為保溫措施，可改善手術中期低體溫發生及提早麻醉甦醒，進而能降低低體溫對患者的影響及照護成本。This quasi-experimental study examined the effect of rewarming strategies on patients receiving abdominal surgery during intraoperative phase in prevention of core hypothermia and postanesthetic recovery. Seventy clients who received abdominal surgery from two hospitals in central Taiwan as a convenient sample were enrolled in this study. The participants were divided into two groups: the experimental group (n=35) used extra warming strategy of the BLANKETROL to keep normothermia and the control group utilized routine thermal management. The instruments used to collect data included demographic data, core temperature, hemodynamic responses, perioperative management, and Fitness for Discharge Scoring System. The result showed that morphometric characteristics were similar in each group except operative time. The results showed that the experimental group (36.41°C ± 0.58) had higher core temperature than the control group (35.83°C ± 0.57, p<.001). The experimental group also had recovery time 41.29 minutes earlier than the control group (p<.001). The study indicated that nurses providing rewarming strategies for maintaining core normothermia can decrease the duration of postanesthetic recovery. Further more, that can reduce costs of care.