体位训练对子宫肌瘤术后患者临床疗效及心理应激反应的影响

The clinical efficacy and postoperative stress response and of postural training for the uterine fibroids by the laparoscopy surgery

目的探讨体位训练对子宫肌瘤术后患者临床疗效及心理应激反应的影响。方法2012年9月到2014年2月选择在我院诊治的子宫肌瘤患者146例,根据随机数字表法分为左侧卧位组73例与平卧位组73例,所有患者都给予腹腔镜下子宫肌瘤切除术,平卧位选择平卧位训练干预,左侧卧位组左侧卧位训练干预。结果对比两组的手术时间及术中出血量,差异无统计学意义(P>0.05),与平卧位组相比,左侧卧位组的术后排气时间与术后住院时间明显较少(P<0.05)。与平卧位组相比,左侧卧位组术后7d内的恶心呕吐、皮下气肿、下肢静脉血栓、低血压等发生情况明显较少(P<0.05)。术前两组患者SAS及S-IS评分比较差异无统计学差异(P<0.05)。术后,平卧位组SAS及S-AI评分明显高于左侧卧位组(P<0.05)。结论相对平卧位,侧卧位训练在腹腔镜下子宫肌瘤切除术中的应用能改善下肢静脉的血液回流,降低应激反应,减少术后并发症的发生,从而促进患者康复。

Objective To investigate the clinical efficacy and postoperative stress response effects of postural training for the uterine fibroids by the laparoscopy surgery. Methods From September 2012 to February 2014,Selected 146 uterine fibroid patients in our hospital,accorded to the random number table were equally divided into the left side group and the supine position group,all patients were given laparoscopic myomectomy,and the supine position group were selected the supine training intervention,the left side group were selected left lateral training intervention. Results The operative time and blood loss compared between the two groups were no significant difference（ P〉0. 05）,but the postoperative exhaust time and postoperative hospital stay in the left side group were significantly less than the supine position group（ P〈0. 05）. The postoperative 7d nausea and vomiting,subcutaneous emphysema,deep vein thrombosis,hypotension complications in the left side group were significantly less than the supine position group（ P〈0. 05）. Compared with before surgery,the SAS and S-SI score of two groups had no significant difference（ P〉 0. 05）,After surgery,the SAS and S-SI score of supine position group were higher than the observation group. Conclusion Compared to the supine position,lateral position training in laparoscopic myomectomy can improve the venous blood reflux, reduce stress, reduce the incidence of postoperative complications,thereby promote the rehabilitation of patients.