Effect of comprehensive thermal insulation measures on body tempreture and stress index in patients with low body mass index of thoracic surgery

Abstract

Objective To investigate the changes of body temperature and the effect of nursing intervention in patients with low body mass index (BMI<18.5 kg/m2) during thoracic surgery. Methods Sixty patients with low BMI who underwent thoracic surgery in the Operating Department of the 4th Hospital of Hebei Medical University from June 2016 to December 2018 were randomly divided into observation group and control group, with 30 cases in each group. In addition, 30 patients with normal BMI (18.5-23.0 kg/m2) who underwent thoracic surgery in the same period were selected as the normal group. The observation group adopted comprehensive thermal insulation measures during the operation, and the control group and the normal group adopted routine insulation measures. The patient's body temperature of three groups was compared at each time point: entering operation room, disinfection, body cavity exploration , cutting specimens, closing the chest, suture skin and exiting operation time. the occurrence of adverse reactions during surgery, the blood coagulation index and lactic acid in the peripheral blood before and at the end of surgery, and the peripheral blood inflammatory factor levels were also compared. Results There were no significant differences in body temperature between the three groups (P>0.05) . During the operation, the body temperature of the three groups decreased, and the recovery from the chest was restored. There were significant differences in body temperature between the three groups (P 0.05) . The coagulation and stress indexes of the observation group and the control group were significantly different from those of the normal group (P 0.05) . The coagulation, lactic acid and stress indexes of the three groups were significantly different before and after surgery (P<0.05) . There was a statistically significant difference in interleukin-6 (IL-6) levels before and after surgery (F=134.241, P< 0.001) ; there was an interaction between the intervention and the time, and the difference was statistically significant (Finteraction=12.202, P<0.001) . There were significant differences between the three groups in the interleukin-10 (IL-10) level group (between group F=7.792, P < 0.001) ; the difference of IL-10 levels before and after surgery was statistically significant (Ftime=112.121, P< 0.001) ; There was an interaction between the intervention and the time, and the difference was not statistically significant (Finteraction=2.990, P=0.055) . Conclusions Compared with patients with normal BMI thoracic surgery, patients with low BMI have abnormal blood coagulation and stress indicators before surgery, and are more likely to have intraoperative blood pressure drop and adverse reactions. Comprehensive intraoperative warming measures can effectively prevent hypothermia in patients with low BMI. Key words: Body mass index; Thoracic surgery; Body temperature; Coagulation function; Stress index