改良体位护理对全麻鼻内镜术后患者安全性及有效性分析

Analysis of safety and effectiveness of modified postural nursing on patients undergoing endoscopic sinus surgery

目的：探讨改良体位护理对全麻鼻内镜手术后患者生命体征的影响和有效性。方法：选择2015年7月-2016年2月我科收治的鼻内镜手术患者127例,将其随机分为观察组74例和对照组53例,观察组采用改良体位护理,对照组采用全麻术后传统体位护理,比较两组患者术后心率、呼吸、血压、经皮血氧饱和度等安全性指标;并记录两组患者的鼻部疼痛、颈肩酸痛程度、术后呛咳、耳闷胀感及紧张焦虑等不良反应。结果：两组患者安全性指标异常情况的发生率差异无统计学意义（P〉0.05）,观察组患者在术后颈肩酸痛、术后呛咳、耳闷胀感、紧张焦虑等不良反应发生率低于对照组（P〈0.05）,疼痛程度轻于对照组（P〈0.05）。结论：全麻鼻内镜手术后患者采用改良体位护理是安全有效的;与传统护理体位相比,改良体位增加了全麻鼻内镜术后患者舒适度,减轻了患者疼痛,改善了患者焦虑、烦躁等不良情绪,有利于患者术后恢复,值得临床推广。

Objective： To explore the effect of modified position nursing on the vital signs of patients after endoscopic surgery under general anesthesia.Methods： Selected 127 patients undergoing endoscopic sinus surgery from July 2015 to February 2016 and randomly divided them into observation group with 74 cases and control group with 53 cases. The control group was treated with modified position while the control group was treated with traditional position after general anesthesia. The postoperative heart rate,respiration,blood pressure and percutaneous oxygen saturation were compared between the two groups. The nasal pain,neck pain,choking,ear stuffy sense of tension and anxiety and other adverse reactions of the two groups were recorded. Results：There was no significant difference between the two groups in the incidence of abnormalities of the safety indexes（P〉0.05）. The incidence of adverse reactions such as neck and shoulder pain,choking,ear swelling,sensation of tension and anxiety were lower in the observation group than that in the control group（P〈0.05）. And the degree of pain was lighter than that of the control group（P〈0.05）. Conclusion： General anesthesia after endoscopic surgery in patients with improved postural care is safe and effective. Compared with the traditional nursing position,improved position can increase the comfort of patients with general anesthesia after endoscopic surgery and it can reduce pain and improve negative emotions of patient such as anxiety,irritability. It is conducive to patients with postoperative recovery and is worthy of clinical promotion.