老年直肠癌患者膀胱截石位术后下肢不同摆放法的护理体会

目的：探讨老年直肠癌患者膀胱截石位术后下肢不同摆放法对血流动力学参数的影响及护理体会。方法：选取2013年1月-2014年1月期间在本院诊治的84例老年直肠癌患者，按照随机数字表法将其分为试验组（术后单腿慢放）和对照组（两腿同时慢放），每组各42例，观察比较两组术前、术后血流动力学参数（心率HR、收缩压SBP、舒张压DBP、中心静脉压CVP）变化，以及体位改为膀胱截石位后1、3、5、10 min，两组上述参数变化情况。结果：试验组术后的HR、SBP、DBP、CVP变化与术前比较差异均无统计学意义（P〉0.05），而术后对照组HR明显增高，SBP、DBP、CVP均明显减少（P〈0.05），且两组术后血流动力学参数比较差异均有统计学意义（P〈0.05）。在体位改为膀胱截石位后1、3、5、10 min时，两组血流动力学参数比较差异均有统计学意义（P〈0.05）。结论：老年直肠癌患者膀胱截石位术后下肢单腿慢放能够明显减少血压和心率的波动幅度，确保围术期的安全性，值得临床推广。

The Nursing Experience of the Difference Placement Methods of Lower Extremity after by Bladder Lithotomy Position Operation for Elderly Patients with Rectal Cancer

To investigate the effect on the hemodynamic parameters and nursing experience of the difference placement methods of lower extremity after by bladder lithotomy position operation for elderly patients with rectal cancer.Method：84 elderly patients with rectal cancer in our hospital from January 2013 to January 2014 were selected, they were divided into the experiment group（single leg slow down）and the control group（legs slow down at the same time）according to the random number table method,42 cases in each group.The hemodynamic parameters such as hear rate（HR）,systolic blood pressure（SDP）,diastolic blood pressure（DBP）and central venous pressure（CVP）on the pre-and post-operation in the two groups,and the mentioned parameters in the two groups after 1,3,5,10 min of the position change into the bladder lithotomy were observed and compared.Result：Compared with the pre-operation,the changes of HR,SBP,DBP and CVP on post-operation in the experiment group were not statistical significance（P〉0.05）. However the HR was significantly increased and the SBP,DBP and CVP were obviously decreased on post-operation in the control group,the differences were statistically significant（P〈0.05）.Compared with the control group,the differences were statistical significance on post-operation in the experiment group（P〈0.05）.After 1,3,5,10 min of the position change into the bladder lithotomy,compared with the control group,the differences of mentioned hemodynamic parameters were statistical significance in the experiment group（P〈0.05）.Conclusion：The single leg slow down after bladder lithotomy position operation can significantly reduce the fluctuation of blood pressure and heart rate for elderly patients with rectal cancer,ensure the safety of peri-operative period,and is worthy of clinical promotion.