低坡卧位在体外循环患者术后早期的应用

Application Effects of Semi-reclining Position for Extracorporeal Circulation Patients in the Early Period after Cardiac Surgery

目的探讨心脏外科体外循环术后早期采取低坡卧位对患者呼吸循环功能及康复效果的影响。方法选择2012年1-3月全身麻醉体外循环术后患者126例,采用随机数字表法分为研究组65例和对照组61例,对照组给予早期低坡卧位并逐步抬高床头,对照组按照全身麻醉术后护理常规,去枕平卧6h。比较两组患者术后6h的呼吸循环功能异常情况、术后1~2d的生命体征、术后置管时间及住院天数。结果研究组患者术后6hSpO2异常及术后1~2d呼吸异常的发生率低于对照组,心包纵隔引流通畅度优于对照组,气管插管及引流管置管时间短于对照组,住院天数少于对照组,差异均有统计学意义(P<0.05或P<0.01)。结论早期低坡卧位、逐步抬高床头的方法有助于促进体外循环术后患者呼吸循环功能的恢复,提高舒适度,缩短术后康复时间。

Objective To explore the application effects of semi-reclining position on respiratory circulation capacity and rehabilitation effects for extracorporeal circulation patients in the early period after cardiac surgery. Methods Totally 126 patients with general anesthesia and extracorporeal circulation were recrui- ted and randomly divided into experimental group （n--65） and control group （n----61）. Patients in the experimental group were given semi-reclining position in the early period after cardiac surgery and gradual- ly raised the head of bed, while patients in the control group were given horizontal recumbent position for 6 hours. Respiratory and circulatory function 6 hours after surgery, vital signs 1 ~ 2 days postoperation, cathetering time and length of stay of the two groups were assessed and compared. Results Incidences of abnormal SpOz 6 hours postoperative and breathing disorder in the experimental group were significantly lower than which in the control group （P^0.05）. Drainage patency of mediastinum in the experimental group were significantly better than which in the control group （P^0.05）,the length of hospital stay, trachea cannula and cathetering time in the experimental group were significantly shorter than which in the control group （P〈0.05 or P〈0.01）. Conclusion Semi-reclining position used in extracorporeal circula- tion patients early after cardiac surgery can promote the recovery of respiratory and circulatory function, prevent complications, shorten the recovery time and improve the rehabilitation quality.