头颈部恶性肿瘤患者全麻术后早期体位的研究  

Postural research for patients early after surgery for head and neck cancer under general anesthesia

作　　者：曾定芬[1] 李晓霞[1] 邱有波[2] 江华[1] 阳静[1] 范玉霞[1] 

机构地区：[1]四川省肿瘤医院头颈外科2病区,四川成都610041 [2]崇州市人民医院外科

出　　处：《护理学杂志》2014年第22期18-21,共4页

摘　　要：目的探讨头颈部恶性肿瘤全麻术后患者早期适宜的体位。方法将头颈部恶性肿瘤全麻术后患者139例采用随机数字表法分成A组、B组、C组,术后早期A组46例取去枕平卧位,B组46例取半卧位,C组47例循序渐进抬高床头至半卧位。观察三组患者的生命体征、血气分析结果、疼痛(头部、肩颈部及腰背部疼痛)、恶心、呕吐、排尿困难、颜面部水肿及术后下床活动等情况,调查患者的舒适度。结果三组头痛、肩颈部疼痛、腰背部疼痛发生情况及疼痛程度比较,差异有统计学意义(均P<0.05),三组呕吐、排尿困难、颜面部水肿发生率及术后下床活动时间比较,差异有统计学意义(P<0.05,P<0.01),三组生命体征、血气分析、恶心等方面比较,差异无统计学意义(均P>0.05)。结论头颈部恶性肿瘤患者全麻术后早期,采用循序渐进的方式抬高床头至半卧位,在保证患者生命体征稳定、不增加呕吐窒息概率的情况下,既可减轻疼痛,预防并发症,还可增加患者的舒适度,促使患者早日下床活动。Objective To explore appropriate and effective position for head and neck cancer patients early after surgery under general anesthesia.Methods Totally,139 head and neck cancer patients after surgery under general anesthesia were divided into group A （n=46）,B （n=46） and C （n=47） according to the random number table,and asked to take a supine position without a pillow,semi-recumbent position and a gradual lift to semi-recumbent position accordingly.Then,the vital signs,blood gas analysis,pain （head,shoulder,neck and lumbar back pain）,vomiting,dysuria,facial edema and postoperative ambulation of the three groups were compared.Results The differences in the headache,shoulder and neck pain,back pain,nausea,vomiting,dysuria,facial edema and postoperative ambulation were significant among the three groups （P＜0.05,P＜0.01）,while the differences in vital signs,blood gas analysis and nausea were insignificant among the three groups （P＞0.05 for all）.Conclusion Postoperative step-by raising the bed to the semi-recumbent position for head and neck cancer patients after general anesthesia can not only relieve patients＇ pain and prevent complications,but also increase their comfort and prompt their early ambulation,in addition to ensuring patients＇ stable vital signs,without increasing the risk of vomiting and choking.

关 键 词：头颈部恶性肿瘤 全麻术后 体位 循序渐进半卧位 护理 

分 类 号：R473.6[医药卫生—护理学]