限制性和非限制性体位对术后病人康复的影响

Contrast Study on the Recovery of Post-operative Patients with Different Posture

目的探讨硬膜外麻醉手术病人回到普通病房后的适宜体位。方法选择健康自愿者50名采用限制性体位即去枕平卧位,测量记录适应时间、忍耐时间、极限时间。选择同期硬膜外麻醉回到普通病房的手术病人300例,随机分为两组,观察组采取非限制性体位,病人可按自己舒适要求,采取任意体位;对照组采取限制性体位,按护理常规去枕平卧6 h。采用双盲法对两组病人舒适度和体位性并发症进行观察和评价。结果健康人去枕平卧适应时间(36.3±7.9)min;忍耐时间(23.6±7.1)min;极限时间(56.6±8.9)min。术后舒适度评价,观察组显著优于对照组(P<0.05),体位性并发症比较对照组较为严重(P<0.05)。结论依据健康人对限制性体位忍耐时间生理学机理,对手术后病人采取非限制性体位,能显著提高舒适度,并且能有效改善体位性并发症的发生情况,有利于病人康复。

Objective To explore a suitable lying posture for post-operative patients undergoing epidural anesthesia.Methods 50 voluntary healthy subjects were selected for a physiological study by taking a limited posture on bed（lying supinely without any pillow）.Evaluation was made according to the following：（1） length of time can be easily adapted to;（2） length of time can be endured tolerably;（3） length of time beyond endurance.Clinical study was done as follows： 300 cases of post-operative patients undergoing epidural anesthesia were divided into experimental group（with free postures） and control group（with limited posture,that is,lying supinely without pillow for six hours）.Comfort of patients and postural complications of both groups were observed and evaluated by double-blind method.Results Healthy people could lie supinely without pillows for（36.3±7.9） min without any discomfort,and for（23.6±7.1） min with endurable discomfort.The time limit beyond endurance was（56.6±8.9） min.Patients in experimental group felt more comfortable than those in control group（P〈0.05）.The incidence of postural complication in experimental group was far lower than that in control group（P〈0.05）.Conclusion Free posture can make patients more comfortable meanwhile lower and prevent the postural complication,which benefits patients＇ recovery.