硬膜外麻醉下行剖宫产手术后产妇两种体位的比较

The comparison on puerpera′s two position after cesarean section under epidural anesthesia

目的:探讨硬膜外麻醉下行剖宫产手术后产妇回母婴同室6 h内不同体位对产妇舒适度及术后不适的影响。方法:选择硬膜外麻醉下行剖宫产手术后神智清醒且生命体征平稳的产妇1220例,将其随机分为对照组和实验组各610例。实验组采用头颈下垫枕、头部抬高10°～15°、可适当翻身的改良低半卧位,对照组采用传统去枕平卧位。比较两组产妇心率>100次/min、呕吐、头晕、腹部疼痛、腰肌酸痛、呼吸频率>20次/min、Ⅰ期压疮发生率及肛门排气时间。结果:两组产妇呕吐、头晕的发生率差异无统计学意义(P>0.05);实验组腰肌酸痛、呼吸频率>20次/min、心率>100次/min、Ⅰ期压疮的发生率低于对照组(P<0.05);腹部疼痛程度轻于对照组(P<0.05);肛门排气时间早于对照组(P<0.05)。结论:硬膜外麻醉下行剖宫产手术后产妇在清醒、生命体征平稳的前提下,回母婴同室6 h内采用改良半卧位较去枕平卧位能减轻产妇术后不适,增加舒适度,有助于促进肛门排气。

Objective：To explore the influence of maternal comfort and postoperative discomfort after cesarean section under epidural anesthesia in deferent position within 6 hours when they were back to mother - to - child room. Methods ： Choosing 1220 cases of lactation in which they were sane and their vital signs performance were stable after cesarean section under epidural anesthesia. They were divided into control group and the experimental group at randon, each group has 610 cases. In the experimental group puerperas who used the improve ment low semi - recumbent position can put the pillow under the head and neck, head up 10 - 15 degrees , and turn over properly. In the control group they used the traditional recument position without pillow. Monitoring each group＇s heart rate, vomiting incidence, headache, dizzy, abdominal pain,waist muscle, ache, breath frequency, stage I pressure ulcer and so on. Then making a comparison. Results ：Two groups＇s vital signs performance are stable . Both the experimental group and the control group don＇t have statistics significance in vomiting and dizzy incidence （P 〉 0.05 ）. But they have statistics significance in waist muscle ache, polynoea （ 〉 20 times/min ）, heart rate （ 〉 100 times/min）, stage I pressure ulcer, abdominal pain intensity and anal exhaust sooner or later（P 〈 0.05 ）. Conclusion：Puerperas who use the improvement low semi - recumbent position can reduce postoperative discomfort,incease comfort level and help anal exhaust than those who use the recument position without pillow after cesare - an section under epidural anesthesia withn 6 hours when they go back to mother - child room under premise that they are sane and their vital signs performance are stable .