不同时点变换头高位对麻醉恢复室全麻患者术后恢复的影响  

The effect ofhead-up tiltshift at differenttime spot on postoperative recovery of patients with general anesthesia in PACU

作　　者：陈丽丽[1] 徐维昉[1] 李丽[2] 李新琳[1] CHEN Lili;XU Weifang;LI Li;LI Xinlin(Department of Anesthesiology,the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China;Operation Room, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China)

机构地区：[1]新疆医科大学第一附属医院麻醉科,乌鲁木齐830054 [2]新疆医科大学第一附属医院中心手术室,乌鲁木齐830054

出　　处：《新疆医科大学学报》2018年第1期25-28,共4页Journal of Xinjiang Medical University

基　　金：新疆维吾尔自治区自然科学基金面上项目(2017D01C287)

摘　　要：目的评价不同时点变换头高位对麻醉恢复室(PACU)全麻患者术后恢复效果的影响。方法选择新疆医科大学第一附属医院麻醉科麻醉恢复室2016年9月符合纳入标准的患者400例,按照随机数字表随机分为4组:Ⅰ组为对照组,从进入麻醉恢复室到出室均为有枕平卧位,Ⅱ组进入恢复室连接呼吸机时床头抬高30°,Ⅲ组拔出气管导管后床头抬高30°,Ⅳ组拔出气管导管后观察10 min后床头抬高30°,分别记录患者生命体征的变化及恶心呕吐、烦躁的发生情况,评估患者的舒适程度及手术部位的疼痛程度。结果 4组患者入PACU时生命体征平稳,4组患者的收缩压、舒张压、心率及氧饱和度比较差异无统计学意义(P>0.05);体位改变后对照组患者恶心呕吐、烦躁的发生率为23%,观察组的发生率分别为14%、7%和15%。Ⅲ组拔出气管导管后床头抬高30°的发生率为7%,与对照组相比差异有统计学意义(P<0.05);手术部位视觉模拟评分法(VAS)疼痛评分对照组得分为(4.80±0.92),实验组得分分别为(4.00±1.15)分、(4.63±0.66)分、(4.29±0.38)分,与对照组相比,Ⅰ组和Ⅲ组差异有统计学意义(P<0.05);患者的舒适度得分,对照组分数为(76.70±6.18),观察组得分分别是(104.10±11.58)分、(102.70±4.59)分、(103.2±3.88)分,与对照组相比,观察组3组的舒适度都较高,差异均有统计学意义(P<0.05)。结论进入麻醉恢复室的插管全麻患者,拔出气管导管后在生命体征平稳的情况下床头抬高30°的体位是最佳体位,其既减少恢复期不良事件的发生率,增加患者的舒适度,又可减轻患者手术部位的疼痛程度,促进患者术后早日康复。Objective To evaluate the effect of head up tilt shift at differenttime spot on patientswithgeneral anesthesiainpostanesthesia care unit(PACU).Methods400patients suitable to the inclusion criteria from Department of Anesthesiology,the First Affiliated Hospital of Xinjiang Medical Universityin September2016were randomly divided into four groups:control groupwitha pillow supine positionwhen entering the PACU till to out of the room,groupⅡwith30degreehead up positionconnecting to the ventilatorwhen entering the PACU,groupⅢwithhead elevation of30degreesafter pulling out the endotracheal tube,groupⅣwith head elevation of30degreesafter10minobservation ofpulling out the tracheal catheter.The changes in the patient′s vital signs and the occurrence of nausea/vomiting and irritability were recorded,and the degree of comfort and the degree of pain at the surgical site were assessed.Results400patients inthe PACU had stable vital signs,and the differences between four groups of patients with systolic blood pressure and diastolic blood pressure,heart rate and oxygen saturation were no statisticsignificance(P>0.05);after changing of position,the incidence rateof nausea/vomiting and irritabilityin the control group patientswas23%,whereas thatin the experimental groups were14%,7%and15%respectively.Compared with the control group,the incidence rate ingroupⅢwas statistically significant;surgical site VAS pain score in the control group was(4.80±0.92),while the experimental group scores were(4.00±1.15),(4.63±0.66)and(4.29±0.38)respectively.There was significant difference between the groupⅠand groupⅢ(P<0.05);Comfort degree score of patients in the control group was(76.70±6.18),while the experimental group scores were(104.10±11.58),(102.70±4.59)and(103.2±3.88)respectively.The comfort degree of the three groups was higher than the control group,and the difference was statistically significant(P<0.05).ConclusionTheintubated patientswith general anesthesiain the post anesthesia care unit,the positionofhead upto30de

关 键 词：麻醉恢复室 全身麻醉 时点 头高位 

分 类 号：R473.6[医药卫生—护理学]