早期下床对主动脉夹层患者术后并发症及舒适感的影响

Effect of early mobilization on postoperative complications and comfort in patients with aortic dissection

目的探讨主动脉夹层患者行腔内隔绝术后12 h下床活动对机体舒适感及并发症的影响。方法选取行腔内隔绝术的主动脉夹层患者240例,采用随机数字表法将其分为对照组和实验组,每组120例。实验组术后手术侧下肢制动并平卧12 h后下床活动,对照组术后手术侧下肢制动并平卧24 h后下床活动。比较两组患者术后24 h腹股沟切口出血、血压波动、舒适度及术后1周的内漏发生情况。结果实验组患者术后并发症发生率为21.67%,对照组术后并发症发生率为25.00%,差异无统计学意义(P>0.05);实验组患者腰背酸痛发生率、腹胀发生率低于对照组(P<0.05),两组患者失眠发生率差异无统计学意义(P>0.05)。结论主动脉夹层患者行腔内隔绝术后12 h下床活动,并不增加内漏、血压波动、腹股沟切口出血的风险,且可以显著降低患者腰背酸痛、腹胀发生率,改善患者的舒适度。

Objective To explore the influence of early mobilization 12 h after operation on the physical comfort and complications in patients with aortic dissection after endovascular exclusion.Methods A total of 240 patients with aortic dissection were divided into two equal groups randomly.The experimental group was encouraged to mobilize and leave bed 12 h after surgery,while the control group was encouraged to mobilizeand leave bed 24 h after surgery.Complications including inguinal incision bleeding,blood pressure fluctuations,and the physical comfort during the 24 h after surgery and internal leakage occurred within one week after surgery were compared between the two groups.Results The occurrence of postoperative complication was 21.66%in the experimental group.In the control group,the occurrence of postoperative complication was 25.00%(P>0.05).The incidence of backache and abdominal distension in the experimental group were lower than those in the control group(P<0.05),and there was no significant difference in the incidence of insomnia between the two groups(P>0.05).Conclusion Early mobilization,that is,leaving bed and mobilize 12 h after sugery,does not increase the occurrence of complications including inguinal incision bleeding,blood pressure fluctuations,and internal leakage in patients with aortic dissection after endovascular exclusion,and can significantly improve the patients'physical comfort.