手术室截石位患者术后体位改变对血流动力学的影响

目的:探讨手术室截石位患者术后体位改变对血流动力学的影响。方法:将我院手术室取膀胱截石位手术的43例患者随机分为实验组22例和对照组21例,对照组术后采用常规双腿同时慢放,实验组患者术后采用单腿慢放,即一腿慢放,轻拍小腿肌肉,做被动屈膝运动,再换另一侧下肢。对两组手术患者术前及体位改变后3 min、5 min、10 min的HR、BP及CVP分别记录,并进行分析。结果:与术前相比较,术后患者HR、SBP、DBP、CVP各种检测值趋于稳定(P<0.05)。体位改变后两组患者3min、5 min、10 min时的HR、BP及CVP均有显著性差异(P<0.05);与对照组比较,实验组术后3 min、5 min、10 min时的HR、BP及CVP变化幅度显著减小(P<0.05)。结论:患者术后体位改变会对血流动力学造成一定的影响,可导致患者血压和心率的波动,采用单腿慢放可以减轻因体位改变给患者带来的不安因素,提高手术成功率。

Influence of postoperative posture change on hemodynamics of patients with lithotomy position in the operation

Objective:To explore the influence of postoperative posture change on hemodynamics of patients with lithotomy position in the operation.Methods:43 patients with lithotomy position in the operation were randomly divided into an experimental group(n=22) and a control group(n=21).The patients in the control group were helped to lay their both legs flat simultaneously and slowly after operation according to the conventional method and the patients in the experimental group were assisted to lay one leg flat slowly,patting the calf muscles and were given passive bending and stretching movement,then changed another one.HR,BP and CVP of the patients in both groups were recorded and analyzed before operation and in 3,5 and 10 minutes after posture change.Results:Compared with those before operation,HR,SBP,DBP and CVP were stable after operation(P<0.05);the differences in the comparison of HR,BP and CVP in 3,5 and 10 minutes after posture change were statistically significant between the two groups(P<0.05);the range of change of HR,BP and CVP in 3,5 and 10 minutes significantly decreased in the experimental group after operation compared with the control group(P<0.05).Conclusion:The postoperative posture change of the patients has an influence on hemodynamics,which can lead to the fluctuations of patients’ blood pressure and heart rate.Therefore the adoption of laying one leg flat slowly after operation can relieve patient’s anxiety caused by posture change so as to increase the success rates of operation.