腰椎间盘摘除术中俯卧位对患者呼吸的影响及护理

Effects or Pronation on Respiration and Its Nursing during Lumbar Discectomy

目的：了解和改善腰椎间盘摘除术中患者俯卧位对呼吸的负面影响。方法：使用AT608一多参数手术监护仪，对36例行硬膜外麻醉取得理想麻醉平面的患者，分别测定仰卧位、腹部垫物俯卧位、支撑点势物俯卧位时，患者的血氧饱和度（SPO2）、呼气末二氧化碳浓度（ET－CO2）。结果：以平卧位所得数值为参考对照值，支撑点垫物俯卧位时SPO2及ET－CO2值变化不明显，无统计学意义。而腹部整物俯卧位所得SPO2及ET－COZ值变化显著，两数值与前两种体位相应数值对比分析，经统计学处理，P＜005。结论：腹部垫物俯卧位对患者的呼吸有明显的影响，改进后的支撑点垫物俯卧位对呼吸无明显干扰，可推广应用。

Objective: To determine the effects of the patient's respiration in the prone position.Methods: The saturation po1nt of oxygen(SPO2)and the concentration of carbon dioxide at the end of expiratory (ET-CO2 )was examined in 36 patients when placed at three different positions by AT-608 polyparameter operation monitor. Results:When the patient was placed in pronation with something on the fulcra (ilia clavicle and acromion),the change of SPO2, and ET-CO2, was insignificant compared with that of the patient who was placed in supination(P >0. 05)- On the contrary. When the patient was placed in pronation with something under the abdomen,the change of SPO2 and ET-CO2 was significant (P <0. 05) compared with that of the other two positions- Conclusion:The negative effects on respiration in pronaton with something under the abdomen were remarkable while the negative effects on respiration were minor when the patient was placed in prone position with something on the fulcra. Therefore,this innovatory position should be introduced.