ABSTRACT
Objective:To investigate the effects of a perioperative whole course composite thermal insulation strategy on complications of cesarean section, maternal coagulation function and serum inflammatory indexes.Methods:A total of 250 pregnant women who were subjected to cesarean section in Zhoushan Hospital between June 2020 and August 2021 were included in this study. The 125 pregnant women who gave birth using a routine simple thermal insulation strategy from June to November 2020 were assigned to the routine simple thermal insulation group, and those who gave birth using a perioperative whole course composite thermal insulation strategy were assigned to whole course composite thermal insulation group. Two groups of pregnant women underwent cesarean section under subarachnoid block. Volume of intraoperative blood loss was recorded. The incidence of complications such as shivering and postoperative infection was calculated. Platelet count, prothrombin time, activated partial thromboplastin time, thrombin time measured before surgery and 48 hours after surgery were compared between the two groups. Peripheral blood white blood cell count, neutrophil count (N%), C-reactive protein, procalcitonin, interleukin-6 measured 48 hours after surgery were compared between the two groups.Results:Volume of intraoperative blood loss in the whole course composite thermal insulation group was significantly lower than that in the routine simple thermal insulation group [(393.84 ± 79.78) mL vs. (434.80 ± 123.49) mL, t = 3.11, P < 0.05). The incidence of shivering and postoperative infection in the whole course composite thermal insulation group was 10.4% (13/125) and 7.2% (9/125), respectively, which was significantly lower than that in the routine simple thermal insulation group [25.6% (32/125), 18.4% (23/125), χ 2 = 9.78, 7.02, both P < 0.05]. At 48 hours after surgery, prothrombin time, activated partial thromboplastin time, thrombin time in the whole course composite thermal insulation group were (10.28 ± 0.48) seconds, (26.97 ± 2.27) seconds, and (14.09 ± 1.36) seconds, respectively, which were significantly shorter than those in the routine simple thermal insulation group [(11.71 ± 0.27) seconds, (27.96 ± 2.25) seconds, (15.91 ± 1.09) seconds, t = 7.34, 3.43, 11.66, all P < 0.05]. At 48 hours after surgery, white blood cell count, neutrophil count, C-reactive protein, procalcitonin, and interleukin-6 in the whole course composite thermal insulation group were (10.38 ± 2.38) ×10 9/L,(0.79 ± 0.06), (52.79 ± 20.73) mg/L, (0.13±0.42) μg/L, and (55.73 ± 24.38) ng/L, respectively, which were significantly lower than those in the routine simple thermal insulation group [(12.24 ± 7.05) × 10 9/L, 0.81 ± 0.05, (65.38 ± 25.92) mg/L, (0.20 ± 0.97) μg/L, (76.22 ± 39.08) ng/L, t = 2.79, 2.92, 4.24, 8.12, 4.97, all P < 0.05]. Conclusion:Perioperative whole course composite thermal insulation strategy can improve the coagulation function of pregnant women who are subjected to cesarean section under subarachnoid block, reduce volume of intraoperative blood loss, and decrease incidence of shivering, inflammatory reaction, and postoperative infection.
ABSTRACT
Objective:To investigate the effects of perioperative whole course thermal insulation strategy on extubation, recovery time, coagulation index and the incidence of complications in patients undergoing thoracoscopic surgery.Methods:A total of 121 patients who underwent thoracoscopic surgery who received treatment in Zhoushan Hospital from October 2016 to February 2018 were included in this study. Among them, 59 patients who underwent thoracoscopic surgery from October 2016 to February 2017 were included in the simple thermal insulation group, and 62 patients who underwent thoracoscopic surgery from October 2017 to February 2018 were included in the whole process thermal insulation group. Before and 24 hours and 72 hours after surgery, platelet count, prothrombin time, activated partial thromboplastin time and thrombin time were compared between the two groups. Postoperative extubation time and recovery time were recorded. The incidence of shivering, restlessness and other complications was analyzed.Results:Postoperative extubation time and recovery time in the whole process thermal insulation group were significantly shorter than those in the simple thermal insulation group [(8.06 ± 4.60) min vs. (13.98 ± 7.22) min, (47.19 ± 12.97) min vs. (56.84 ± 17.49) min, t = 5.40, 3.47, both P < 0.05). At 24 and 72 hours after surgery, platelet count and activated partial prothrombin time in the whole process thermal insulation group were significantly shorter than those in the simple thermal insulation group [(12.55 ± 0.88) s vs. (13.11 ± 0.97) s, (27.44 ± 2.43) s vs. (29.03 ± 2.14) s, (11.42 ± 0.73) s vs. (11.87 ± 0.74) s, (27.44 ± 1.96) s vs. (28.80 ± 2.22) s, t = 3.32, 3.81, all P < 0.05). The incidence of postoperative shivering and restlessness in the whole process thermal insulation group was significantly lower than that in the simple insulation Group (7 cases vs. 27 cases, 5 cases vs. 22 cases, χ2 = 17.782, 14.894, 3.33, 3.57, all P < 0.05). Conclusion:Perioperative whole course thermal insulation strategy can shorten extubation and recovery time, inhibit perioperative coagulation dysfunction, and decrease the incidence of perioperative restlessness, shivering and other complications caused by hypothermia. The effect of perioperative whole course thermal insulation is superior to that of simple thermal insulation.