围手术期保温对胃癌手术患者凝血功能和应激指标的影响研究

摘要

Objective To investigate the effect of perioperative heat preservation on blood coagulation and stress in-dexes in patients with gastric cancer. Method 250 cases of gastric cancer patients were included in the analysis, and were randomized into study group (n=220) or control group (n=230), all patients were administered with conventional perioperative treatment, while heat preservation was additionally given in study group. The blood coagulation and stress indexes before and after surgery in both groups were observed, and the postoperative VAS and satisfaction were com-pared. Result The PT, APTT, TT and other related blood coagulation measures before surgery of both groups were simi-lar, while those were increased, but all remained stable in study group;There was no significant difference in preoperative blood glucose, cortisol, insulin, TNF-αbetween the two groups, while all were increased after surgery, with significant differences observed in study group (P<0.05);The postoperative VAS score was lower, while satisfaction rate was higher in study group than that in control group (P<0.05). Conclusion Perioperative heat preservation can significantly improve the coagulation function and stress reaction in patients with gastric cancer, with acceptable postoperative satisfaction.%目的：探讨围手术期保温对胃癌手术患者凝血功能和应激指标的影响。方法以250例接受手术治疗的胃癌患者为研究对象，并将其随机分为保温组220例和未保温组230例，未保温组给予常规围手术期治疗，保温组在此基础上给予围手术期保温措施。观察两组患者手术前后凝血功能指标和应激指标的差异，比较两组患者术后VAS得分和满意度的差异。结果手术前两组患者PT、APTT、TT凝血功能指标无明显差别，手术后，未保温组的PT、APTT、TT水平较手术前升高，而保温组上述指标均较术前无明显改变。两组患者手术前的血糖、皮质醇、胰岛素、TNF-α指标水平无明显差别，手术后两组上述指标水平较手术前增高，而未保温组增高更明显（P﹤0.05）。保温组患者术后VAS得分较未保温组低，满意度较未保温组高，差异具有统计学意义（P﹤0.05）。结论围手术期保温可明显改善胃癌手术患者凝血功能和应激反应，对提高患者术后满意度有较好的作用。