笔尖式细针行低浓度腰麻术后自由体位对患者舒适度的影响  

The Influence of Free-posture of Patients on Their Comfort Degree after the Surgery under Nib-shaped Fine Needle Peformed Low-concentration Lumbar Anesthesia

作　　者：于栋娟 卫亮 战丽惠 YU Dong-juan;WEI Liang;ZHAN Li-hui(Weihai City's Hospital of TCM,Affiliated of Shandong University of TCM and Medica Materia,Shandong264200)

机构地区：[1]山东省中医药大学附属威海市中医院,山东威海264200

出　　处：《中国肛肠病杂志》2023年第3期50-52,共3页Chinese Journal of Coloproctology

摘　　要：目的:探讨肛肠手术应用笔尖式细针行低浓度腰麻,术后自由体位对患者舒适度的影响。方法:选取2021年6月至2022年6月,本院180例ASAⅠ~Ⅱ级择期行腰麻手术的肛肠疾病患者,随机分成观察组和对照组,各90例。观察组应用25G笔尖式穿刺针行低浓度腰麻,术后取自由体位;对照组应用25G笔尖式穿刺针行低浓度腰麻,术后采取去枕平卧6 h体位。观察2组麻醉效果、双下肢运动阻滞评分、术后头痛、腰背痛及尿潴留发生率。结果:2组手术时间、麻醉效果、双下肢运动阻滞评分和术后头痛的发生率比较,差异无统计学意义(P>0.05);观察组术后腰背痛及尿潴留的发生率显著低于对照组(P<0.05)。结论:肛肠科日间手术采用25G笔尖式细针行单次低浓度腰麻,下肢肌力恢复快,笔尖式细针创伤小,术后采取自由体位并不增加腰麻后头痛的发生率,顺势降低了腰背痛及尿潴留的发生率,不必按常规术后去枕平卧6 h,在安全的前提下能改善患者术后舒适度,提高了满意度。Objective To investigate the influence of free-posture of patients on their comfort degree after the surgery under nib-shaped fine needle performed low concentration lumbar anesthesia. Methods Randomly divided the 180 patients with ASAⅠ-Ⅱ grade coloproctolgoical diseases to be subject to scheduled operation under lumbar anesthesia in authors' hospital(2021-06-2022-06) into observation group(90 cases, under low-concentration lumbar anesthesia through 25G nib-shaped puncture needle, after surgery patients took free-posture) and control group(90 cases, using 25G nib-shaped puncture needle to make low-concentration lumbar anesthesia, but after surgery patients took horizontal position without pillow for 6hrs);then, observed and compared both groups' anesthesia efficacy, the ratings on double-leg motor blockage, postoperative headache and lumbodorsal pain, as well as uroschesis incidence. Results In operating time, anesthesia efficacy, the ratings on double-leg motor blockage, and the incidence of postoperative headache there was no statistical difference between the two groups(P>0.05),but, in the incidence of postoperative lumbodorsal pain and uroschesis observation group was significantly lower than control group(P<0.05). Conclusion In coloproctological department's day operation using 25G nib-shaped fine needle to take low-concentration lumbar anesthesia singly can make leg-muscle strength fastly recovered, less trauma, also, after surgery patients adopting free-posture does not increase the incidence of post-lumbar anesthesia headache, further reduce lumbodorsal pain and uroschesis, therefore, not necessaryly ordering patients at horizontal position without pillow for 6 hrs.like routine surgery;thus, only if safe, can improve patients' postoperative comfort degree, and enhance their satisfaction.

关 键 词：肛肠手术 笔尖式细针 低浓度腰麻 自由体位 

分 类 号：R614[医药卫生—麻醉学]