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目的探讨基于乌司他丁的小儿先天性心脏病体外循环术后体温的护理干预方法与价值。方法研究对象是2011年8月—2015年4月由哈尔滨医科大学附属第二医院接收并医治的76位先天性心脏病儿童,通过随机数字表法进行分组,即对照组和观察组,每组患儿均为38例,2组都给予体外循环,在此基础上观察组灌注含有乌司他丁的肺保护液,同时给予积极的护理干预。结果观察组术后2 h的体温[(37.46±0.43)℃]与术后24 h的体温[(38.28±0.56)℃]都明显高于对照组[(36.12±0.48)℃、(36.78±0.46)℃,P<0.05]。观察组的呼吸机辅助时间[(27.45±5.33)d]与术后住院时间[(23.45±4.31)d]明显少于对照组[(41.98±6.13)d、(27.93±4.09)d,P<0.05]。2组术后24 h的颈静脉血氧饱和度(jugular venous oxygen saturation,Sjv02)值和血清肿瘤坏死因子-α(tumor necrosis factor,TNF-α)值都明显高于术前(均P<0.05),不过观察组术后24 h的Sjv02值[(72.48±6.09)%]和血清TNF-α值[(7.98±2.14)pg/ml]明显低于对照组[(84.20±5.68)%、(8.89±1.54)pg/ml,均P<0.05]。结论基于乌司他丁的小儿先天性心脏病体外循环术后体温的护理干预能有效抑制促炎因子的释放,降低脑氧代谢,从而有利于术后体温的保持,促进患儿的康复。
Objective To investigate the method and value of nursing intervention on body temperature after extracorporeal circulation in children with congenital heart disease based on ulinastatin. Methods The subjects were 76 children with congenital heart disease received and cured from the Second Affiliated Hospital of Harbin Medical University from August 2011 to April 2015. The children were divided into two groups by random number table: control group and observation group, each group All of the children had 38 cases. Both groups were given cardiopulmonary bypass. On the basis of this, the observation group was infused with lung protective solution containing ulinastatin, meanwhile positive nursing intervention was given. Results The body temperature (37.46 ± 0.43) ℃ and body temperature at 24 h after operation (38.28 ± 0.56) ° C in observation group were significantly higher than those in control group [(36.12 ± 0.48) ℃ and (36.78 ± 0.46) ) ° C, P <0.05]. The ventilator-assisted time in the observation group was significantly lower than that in the control group [(27.45 ± 5.33) d vs (23.45 ± 4.31) d [(41.98 ± 6.13) d vs (27.93 ± 4.09) d, P < 0.05]. The values of jugular venous oxygen saturation (Sjv02) and serum tumor necrosis factor (TNF-α) in the two groups at 24 hours after operation were significantly higher than those before operation (all P <0.05 ), But the Sjv02 value (72.48 ± 6.09%) and serum TNF-α [(7.98 ± 2.14) pg / ml] in the observation group at 24 hours after operation were significantly lower than those in the control group (84.20 ± 5.68)% and 8.89 ± 1.54) pg / ml, all P <0.05]. Conclusion The ulinastatin-based pediatric congenital heart disease after extracorporeal circulation temperature nursing intervention can effectively inhibit the release of proinflammatory cytokines and reduce cerebral oxygen metabolism, which is conducive to the maintenance of postoperative body temperature and promote the rehabilitation of children.