全麻下全子宫切除术后卧位及卧床时间分析

Analysis of lying position and the length of lying in bed after hysterectomy under general anesthesia

目的 通过对全子宫切除术后患者的卧位及卧床时间进行观察分析，找到该病全麻术后最佳卧位及卧床时间，从而提高患者的舒适感并减少并发症的发生。方法 选择2010年至2013年本院收治的腹腔镜全子宫切除全麻手术的85例患者，随机分为实验组和对照组，对照组在术后去枕平卧6小时，头偏向一侧，6小时后垫枕平卧，术后24小时半卧位。实验组在术后去枕平卧4小时，头偏向一侧，4小时后垫枕平卧，每3小时翻身一次，术后16小时后半卧位。比较两组术后感觉和并发症情况。结果 实验组与对照组患者在不同的卧位及卧床时间条件下，收缩压、舒张压、脉搏及体温等均在正常值范围内，且无显著性差异（t值分别为0．318、0．253、0．421、0．784，均P＞0．05）。实验组中患者术后的腰背部及脖子不适发生率较对照组显著降低（χ^2=6．612，P＜0．05），而腹腔内出血、肠胃不适、神经麻痹和发热等发生率无显著性差异（χ^2分别为0．478、0．035、0．003、0．382，均P＞0．05）。结论 患者采用实验组卧位及卧床时间可提高舒适感，加快恢复速度。

Objective To observe the effect of lying position and the length of lying in bed on the comfort degree and complications of patients after hysterectomy under general anesthesia .Methods From 2010 to 2013 85 patients undergoing laparoscopic hysterectomy under general anesthesia were randomly divided into test group and control group for observation .Patients in the control group lay in firm bed flatly without pillows for 6 hours, and they kept their heads aside .Six hours later, the patients lay in bed flatly with pillows, and 24 hours later they kept half-lying position in common bed .For the test group , patients lay in firm bed flatly without pillows for 4 hours with their heads aside.Four hours later, they were given pillows and kept in bed flatly , but were turned over every 3 hours.Sixteen hours later, patients took half-lying position in common bed .The postoperative comfort degree and complications were compared between two groups . Results The systolic blood pressure , diastolic blood pressure , pulse and temperature of two groups were normal under different recumbent position and length in bed, and there were no significant differences （t value was 0.318, 0.253, 0.421 and 0.784, respectively, all P〉0.05）.The incidence of lower back and neck discomfort in the test group was significantly lower than in the control group （χ^2=6.612, P〈0.05）, but there was no significant difference in the incidence of intraperitoneal hemorrhage , gastrointestinal discomfort, nerve palsy and fever between two groups （χ^2value was 0.478, 0.035, 0.003 and 0.382, respectively, all P〉0.05）.Conclusion The lying position and length of lying in bed of the test group can improve comfort degree and accelerate recovery .