摘要
目的：探讨体位护理预防腰硬联合麻醉下剖宫产术时仰卧位综合征的效果。方法选取2015年2—8月期间北京友谊医院产科在腰硬联合麻醉下行择期剖宫产术的健康初产妇40人为研究对象，将她们随机分为干预组和对照组各20人。腰硬联合麻醉后护士将干预组手术床向左侧旋转，将孕妇右侧抬高30～45°，对照组孕妇采用平卧位。两组分别予持续心电监护，比较两组孕妇麻醉前、麻醉成功翻身后即刻、5～10 min、胎儿娩出后30 min 对应时点血压、脉搏和仰卧位综合征发生情况。结果干预组和对照组在麻醉后 5～10 min 内平均血压分别为128／76 mmHg、106／70 mmHg，平均脉搏分别为89次／min、96次／min，二者差异均有统计学意义（P ＜0．05）。而在麻醉前、麻醉成功翻身后即刻、胎儿娩出后30 min 两组孕妇的血压和脉搏无显著差异（P ＞0．05）。麻醉成功翻身后有 5～10 min 内干预组和对照组发生仰卧位综合征发生率分别为15％（3／20）和65％（1 3／20），差异有统计学意义（P ＜0．05）。结论腰硬联合麻醉下剖宫产术时，麻醉后将孕妇右侧抬高30～45°，在麻醉后 5～10 min 内可避免约一半患者发生仰卧位综合征。
Objective To investigate the effects of posture care on prevention of supine hypotensive syndrome during caesarean section under combined spinal and epidural anesthesia（CSEA）.Methods A total of 40 healthy primiparas who were performed scheduled caesarean section under CSEA from February to August in 201 5 at Beijing Friendship Hospital were selected as study objects,which were then divided randomly into intervention group and control group with 20 cases in each.After the implementation of CSEA in intervention group,nurses turned the operation tables to the left so as to raise about 30 -45°of the right side of the primiparas,while in control group primiparas were using supine position after CSEA.Continuous electrocardio-graphic （ECG）monitoring was applied to both groups,and the blood pressures,pulses and occurrence of supine hypotensive syndrome were compared between the two groups at different time points：before CSEA, shortly after turning back of body position from CSEA procedure,5 -1 0 min after CSEA and 30 min after delivery.Results The average blood pressures were 1 28 /76 mmHg and 1 06 /70 mmHg and mean pulses were 89 times/min and 96 times/min 5 to 1 0 minute after anesthesia in intervention group and control group （P 〈0.05）.While there was no significant difference of blood pressure and pulse between the two groups before CSEA,shortly after turning over from CSEA and 30 min after delivery （P 〉0.05）.The incidences of supine hypotensive syndrome were 1 5% （3 /20）and 65% （1 3 /20）for intervention group and control group 5 min after CSEA （P 〈0.05）.Conclusions The posture care by lifting 30 -45°of the right side of primiparas after CSEA can prevent about half of primiparas from supine hypotensive syndrome 5 -1 0 min after CSEA during caesarean section.
出处
《中华现代护理杂志》
2016年第16期2295-2297,共3页
Chinese Journal of Modern Nursing
关键词
剖宫产
腰硬联合麻醉
体位护理
仰卧位综合征
Caesarean section
Combined spinal and epidural anesthesia
Posture care
Supine hypotensive syndrome
