硬膜外麻醉剖宫产术后6h内产妇体位的探讨

目的 探讨硬膜外麻醉剖宫产术后6h内产妇合适体位，常规去枕平卧位有无必要性。方法 行硬膜外麻醉剖宫产术后的产妇109例，根据住院号单双数随机分为两组，观察组59例术后返回病房即给予垫枕，术后1～2h协助产妇翻身更换体位，按产妇需要取左侧卧位、右侧卧位或平卧位，对照组50例按常规去枕平卧位6h。观察两组产妇头痛，枕后项部及腹背部酸痛不适感、恶露排出、新生儿早吸吮情况。结果 两组比较头痛无统计学意义（P〉0．05）；两组枕后项部及腰背部酸痛不适感比较有显著性差异（P〈0.01），观察组较对照组卧位舒适；两组新生儿早吸吮比较有显著性差异（P〈0．05），观察组利于新生儿早吸吮。结论 硬膜外麻醉刮宫产术后6h内无需去枕平卧位预防头痛，应取垫枕自由体位。

Discussion on the Body Position within 6 Hours after Caesarean Section under Epidural Anesthesia

Objective To study the suitable body position within 6 hours after caesarean section under epidural anesthesia and whether it is requisite to maintain recumbent position without pillow as a routine.Methods One hundred and nine puerperas after caesarean section under epidural anesthesia were randomly divided into two groups according to the odd or even registration number.The puerperas in the observation group were supplied with a pillow instantly after back to the ward.They changed their body position every 1 to 2 hours under the assistance after operation.They were allowed to take left-lateral position,right-lateral position or recumbent position according to their own desire.The puerperas in the control group were routinely taken recumbent position without pillows.Then the authors observed and compared the headache,discomfortableness in occiput and neck,backache,effluence of lochia and early suck of the neonatal between two groups.Results There was no statistically significant difference in the incidence rate of headache between two groups(P>0.05),while the incidence rate of discomfortableness was significantly different in statistics between two groups(P<0.0l).Moreover,there was statistically significant difference in effluence of lochia and early suck of the neonatal between two groups.Conclusion It is unnecessary to keep prostrate position without pillows to prevent the occurrence of headache for puerperas after caesarean section under epidural anesthesia,and free body position without pillows should be taken clinically.