体位调节对预防俯卧位椎动脉内径变窄的效果  

Effect of position adjustment on prevention of narrowing of vertebral artery inner diameter in prone position

作　　者：庄敏[1] 林萍[1] 虞瑾华[1] 朱振中[1] 

机构地区：[1]上海交通大学附属第六人民医院,上海200233

出　　处：《上海护理》2016年第2期5-8,共4页Shanghai Nursing

摘　　要：目的探讨体位调节对于预防俯卧位椎动脉内径变窄的效果,以及对改善患者舒适度的意义。方法于2013年7月—2014年7月招募60名健康志愿者随机分为两组,均使用超声测量仰卧位时双侧椎动脉内径(vertebral artery inner diameter,VAID)作为正常值参考。观察组取俯卧位,通过体位调节使双侧VAID尽可能接近正常值,记录VAID变化值(△D观察);对照组同样取俯卧位,但不进行体位调节,测量双侧VAID,记录VAID变化值(△D对照)。两组被试者在保持俯卧位2 h后,分别采用视觉模拟评分法(VAS)及眩晕残障程度评定量表(DHI)评估头颈部疼痛及及眩晕情况。结果观察组VAID变化不明显(P=0.67),△D观察=(0.08±0.03)mm;对照组VAID变化明显(P<0.01),△D对照=(0.91±0.18)mm;在头痛及头晕评估中,观察组得分明显低于对照组(P<0.05)。结论通过对健康受试者的研究发现,调整头部体位可以有效防止俯卧位VAID变窄,对于降低俯卧位术后头痛和眩晕的发生率、提高患者舒适度将有积极意义。Objective To study the effect of position adjustment on prevention of narrowing of vertebral artery inner diameter（ VAID） in prone position,as well as its value in promoting comfort degree of patients. Methods From July 2013 to July 2014,a total of 60 healthy volunteers were recruited and randomly divided into two groups. The bilateral VAIDs of all volunteers in supine position were measured by ultrasound and used as normal reference values. The volunteers in the experimental group took prone position and adjusted position to keep their bilateral VAIDs as close as possible to the normal reference values. The difference in VAIDs between supine position and prone position was recorded as △Dexperimental. The bilateral VAIDs of the volunteers in the control group were measured in prone position without any position adjustment,and the difference in VAIDs between supine position and prone position was recorded as △Dcontrol. After maintaining the prone position for2 h,Visual Analogue Scale（ VAS） and Dizziness Handicap Inventory（ DHI） scale were used to evaluate degree of headache and dizziness. Results After position adjustment in proper position, there was no significant difference in bilateral VAIDs between supine position and prone position in the experimental group（ P = 0. 67）. △Dexperimentalwas（ 0. 08 ± 0. 03） mm. There were significant differences in bilateral VAIDs between supine position and prone position in the control group（ P 〈0. 01）. △Dcontrolwas（ 0. 91 ± 0. 18） mm.The comfort degree in the experimental group was significantly higher than that in the control group（ P 〈0. 05）.Conclusion Position adjustment could effectively prevent the narrowing of VAID in prone position,decrease postoperative headache and dizziness, and improve the comfort degree of patients.

关 键 词：手术体位 体位调节 俯卧位 椎动脉内径 B超 患者舒适度 疼痛 眩晕 

分 类 号：R473.6[医药卫生—护理学]