Effect of systematic graded rewarming intervention on shivering and postoperative cognitive function in elderly patients undergoing orthopaedic surgery
XU Jiaojiao SHI Guimei RAO Lie LU Xiaomei#br#
Operating Room,Jiujiang Hospital of Traditional Chinese Medicine,Jiangxi Province,Jiujiang 332000,China
Objective To explore the effect of systematic graded rewarming intervention in elderly patients undergoing orthopaedic surgery.Methods A total of 92 elderly patients who underwent orthopedic surgery in Jiujiang Hospital of Traditional Chinese Medicine from March 2019 to March 2022 were selected as the research objects and divided into control group and observation group according to the random number table method,with 46 cases in each group.The control group received routine rewarming intervention,the observation group implemented systematic and graded rewarming measures,and the two groups continued to intervene until the end of the operation.The temperature changes of the two groups were compared at different time periods(after entering the operating room[T1],after induction of anesthesia[T2],30 min of anesthesia[T3],60 min of operation[T4],and the end of operation[T5]).The cognitive function and coagulation function of the two groups were compared before and after intervention.The total incidence of complications was compared between the two groups.Results There was no significant difference in body temperature between the two groups after operation room(T1)(P>0.05).The temperature of the observation group at T2,T3,T4 and T5 were(36.52±0.26),(36.49±0.31),(36.47±0.37)and(36.56±0.32)℃respectively,which were higher than those of the control group of(36.21±0.24),(36.01±0.28),(35.82±0.35),(35.94±0.42)℃,with statistically significant differences(P<0.05).After the intervention,the score of mini-mental state examination(MMSE)in the observation group was(20.25±3.41)point,which was higher than that in the control group of(17.86±3.39)points,the difference was statistically significant(P<0.05).After the intervention,the thrombin time(TT)in the observation group was(18.56±1.30)s,prothrombin time(PT)in the observation group was(15.96±1.32)s,activated partial thromboplastin time(APTT)in the observation group was(31.25±2.83)s,which were longer than those in the control group of(14.89±1.29),(11.08±1.28),(25.39±2.54)s,and fibrinogen(FBG)in the observation group was(2.15±0.38)g/L,which was lower than that in the control group of(3.62±0.53)g/L,the differences were statistically significant(P<0.05).The total incidence of complications in the observation group was 4.35%,which was lower than 17.39% in the control group,the difference was statistically significant(P<0.05).Conclusion Systematic graded rewarming intervention can maintain the body temperature of elderly orthopaedic patients in a constant state,improve postoperative cognitive function and coagulation function,and reduce the risk of complications such as shivering.