【摘要】 目的 探讨手术室温暖护理在急性结石性胆囊炎患者中的应用效果，旨在降低急性结石性胆囊炎手术患者身心应激反应。方法 选取2021年1—12月江苏省东台市人民医院肝胆外科急性结石性胆囊炎患者80例作为研究对象，按照组间基线资料具有可比性原则分为对照组及观察组，每组40例。对照组患者给予常规护理，观察组患者给予手术室温暖护理。比较两组患者心理应激状态（焦虑、恐惧）、生理应激（心率、平均动脉压）、术后康复情况、护理满意度及Kolcaba舒适状况量表（GCQ）评分。结果 术前1 d，两组患者阿姆斯特丹术前焦虑与信息量表（APAIS）、视觉模拟尺（VAS）评分比较差异无统计学意义（P>0.05）；术前5 min，两组患者APAIS、VAS评分均较术前1 d提高（观察组APAIS组内比较t=6.351,P=0.000;VAS组内比较t=6.043,P=0.000。对照组APAIS组内比较t=8.023,P=0.000;VAS组内比较t=8.492,P=0.000），且观察组患者APAIS、VAS评分低于对照组，组间比较差异有统计学意义（P<0.05）。进入手术室等待间时，两组患者心率、平均动脉压比较差异无统计学意义（P>0.05）。麻醉前5min，两组患者心率、平均动脉压均较进入手术室等待间时提高，组内比较差异有统计学意义（观察组心率组内比较t=4.328,P=0.000；观察组平均动脉压组内比较t=10.471,P=0.000。对照组心率组内比较t=10.471,P=0.000；观察组平均动脉压组内比较t=8.324,P=0.000），且观察组患者心率、平均动脉压均低于对照组，差异具有统计学意义（P<0.05）。观察组患者术后首次排气、肠鸣音恢复时间短于对照组，差异有统计学意义（P<0.05）；两组下床活动时间以及住院时间比较，差异无统计学意义（P>0.05）。观察组患者护理满意度高于对照组（P<0.05）。术前1 d，两组患者舒适度比较差异无统计学意义（P>0.05）。术后当天，两组患者舒适度评分较术前1 d提高（观察组组内比较t=24.805,P=0.000；对照组组内比较t=16.472,P=0.000），且观察组患者高于对照组，差异具有统计学意义（P<0.05）。结论 手术室温暖护理在急性结石性胆囊炎手术患者中的运用，有助于减轻患者对手术的心理与生理应激，可促进术后康复。更多还原

【Abstract】 Objective To explore the application effect of warm nursing in the operating room in patients with acute stone cholecystitis, aiming to reduce the physical and mental stress response of patients with acute stone cholecystitis surgery. Methods To select 80 patients with acute stone cholecystitis in the Department of Hepatobiliary Surgery of Dongtai People’s Hospital admitted from January to December 2021 as the study objects,they were divided into a control group and an observation group according to the principle that baseline data between the groups were comparable, with 40 cases in each group. The patients in the control group were given conventional nursing care, and the patients in the observation group were given warm nursing care in the operating theatre. The two groups were compared in terms of psychological stress(anxiety, fear), physiological stress(heart rate, mean arterial pressure), postoperative recovery, nursing satisfaction and Kolcaba General Comfort Questionnaire(GCQ) score. Results 1 d before surgery, the difference between the Amsterdam Preoperative Anxiety and Information Scale(APAIS) and Visual Analogue Scale(VAS) scores of the two groups of patients was not statistically significant(P>0.05); 5 min before surgery, the APAIS and VAS scores of the two groups of patients improved compared with 1 d before surgery(APAIS intra-group comparison of the Observation group t=6.351, P=0.000: VAS intra-group comparison of the observation group t=6.043, P=0.000. In the control group,APAIS intra-group comparison t=8.023, P=0.000: VAS intra-group comparison t=8.492, P=0.000), and APAIS and VAS scores of the patients in the observation group were lower than those in the control group, and the difference between the groups was statistically significant(P<0.05). Entering the waiting room of the operating room, there was no statistically significant difference in the comparison of heart rate and mean arterial pressure between the two groups(P>0.05). 5 minutes before anaesthesia, the heart rate and mean arterial pressure of the two groups of patients were higher than when they entered the waiting room of the operating theatre, and the difference was statistically significant in the intra-group comparison(heart rate of the observation group within the intragroup comparison t=4.328, P=0.000: average arterial pressure of the observation group within the intra-group comparison t=10.471, P=0.000.(Heart rate in the control group t=10.471, P=0.000; average arterial pressure in the observation group t=8.324, P=0.0000), and heart rate and average arterial pressure in the observation group were lower than those in the control group, the difference was statistically significant(P<0.05). The first postoperative venting and bowel sound recovery time of patients in the observation group was shorter than that of the control group, and the difference was statistically significant(P<0.05); there was no statistically significant difference in the time of getting out of bed and the length of hospitalisation between the two groups(P>0.05). The nursing satisfaction of patients in the observation group was higher than that of the control group(P<0.05). 1 d before the operation, the difference between the two groups of patients’ comfort was not statistically significant(P>0.05). On the postoperative day, the comfort scores of patients in the two groups increased compared with that of the preoperative 1 d(t=24.805, P=0.000 for intra-group comparison in the observation group: t=16.472,P=0.000 for intra-group comparison in the control group), and the patients in the observation group were higher than those in the control group, and the difference was statistically significant(P<0.05). Conclusion The use of operating theatre warm care in patients undergoing surgery for acute calculous cholecystitis helps to reduce the psychological and physiological stress of surgery and can promote postoperative recovery.更多还原