术后体位改变方式对贲门癌患者生命体征的影响

Effects of different ways to change body positions on vital signs in postoperative patients with cancenoma of gastric cardia

目的探讨术后体位改变方式对贲门癌患者生命体征的影响。方法通过计算机产生的随机序列将105例贲门癌根治术患者随机分为Ⅰ组、Ⅱ组、Ⅲ组各35例。在术后生命体征平稳的前提下,改变体位,Ⅰ组由仰卧位0°改为50°半卧位;Ⅱ组由仰卧位0°改为30°半卧位,10min后再将体位改为50°半卧位;Ⅲ组仰卧位0°改变为15°低坡卧位,10min后改为30°半卧位,再10min后改为50°半卧位。分别记录三组患者体位改变前后的体温、脉搏、呼吸、血压变化及恶心发生情况。结果体位改变后三组脉搏、呼吸、收缩压、舒张压测量值及恶心发生率比较,差异有统计学意义(P<0.05,P<0.01);Ⅰ组脉搏、呼吸、收缩压、舒张压及恶心发生率相对较高;组内比较,Ⅰ组除体温外,其余各项指标体位改变前后差异有统计学意义(均P<0.01)。Ⅱ、Ⅲ组各项指标体位改变前后组内比较差异无统计学意义(均P>0.05)。结论术后逐步改变体位方式(先由0°至30°,10min后再改变至50°)可避免由体位突然改变而引起的生命体征波动,减轻患者的不舒适感。

Abstract： Objective To evaluate the effect of d different ways to change body positions on vital signs in postoperative patients with cancenoma of gastric cardia. Methods Totally 105 patients undergoing surgery for cancenoma of gastric cardia were included and randomly divided into group Ⅰ , group Ⅱ and group Ⅲ , each of 35. Posture change started when the patients＇vital signs became stable. Group Ⅰ had their position changed from supine 0° to 50° semireclining position. Group II firstly had their position changed from supine 0° to 30° semireclining position, then to 50° semireclining position ten minutes later. Group Ⅲ had their position changed from 0° to 15° low slope position, to 30° semireclining position 10 minutes later, and then to 50° semireclining position still 10 minutes later. The temperature, pulse, respiration, blood pressure and the existence of nausea were recorded and compared be tween the 2 groups. Results Significant differences were observed among the three groups in all the measurements after the position change （P（0.05 ,P〈0.01）. All measurements except the temperature （P）0.05） in group I were significantly higher than those in group Ⅱ and group Ⅲ after the position change （P^0.01 for all）. Significant differences were observed in all the measurements except the temperature, of group Ⅰ , before and after the intervention（P〈0.01 for all）. However, position change had no impact on all indicators within group Ⅱ or group Ⅲ （P〉0.05 for all）. Conclusion Position change supine from 0° to 30° semireclining, then to 50° semireclining position ten minutes later can avoid fluctuation of vital signs and minimize discomfort of patients.