体位干预防治剖宫产术产妇仰卧位低血压综合征的效果

目的研究体位干预防治剖宫产产妇仰卧位低血压综合征(SHS)的效果。方法回顾性分析2018年12月至2019年12月收治的86例剖宫产产妇的临床资料,按照护理方法的不同将其分为参照组和体位干预组,每组43例。麻醉后,参照组采取将手术床朝向左侧并倾斜30°的体位进行护理,体位干预组采取将孕妇右侧臀部垫起4~5 cm的体位进行护理。比较两组麻醉前、麻醉20 min后舒张压、收缩压、呼吸频率、心率及麻黄碱药物使用量、不良事件发生率、新生儿Apgar评分、产妇NSNS评分。结果麻醉20 min后,两组的舒张压、收缩压低于麻醉前,但体位干预组明显高于参照组,差异具有统计学意义(P<0.05);麻醉20 min后,两组的呼吸频率、心率高于麻醉前,但体位干预组明显低于参照组,差异具有统计学意义(P<0.05)。体位干预组麻黄碱药物使用量为(5.23±1.05)mg,明显少于参照组的(8.14±1.77)mg,差异具有统计学意义(P<0.05)。体位干预组术中低血压综合征、单侧阻滞不全、低氧血症发生率均明显低于参照组,差异具有统计学意义(P<0.05)。体位干预组新生儿Apgar评分及孕妇NSNS评分均明显高于参照组,差异具有统计学意义(P<0.05)。结论剖宫产产妇采用特殊体位干预对防治SHS的效果显著,值得推广应用。

Effect of postural intervention on the prevention and treatment of supine hypotension syndrome in puerperae undergoing cesarean section

Objective To study the effect of postural intervention on the prevention and treatment of supine hypotension syndrome(SHS)in puerperae undergoing cesarean section.Methods The clinical datas of 86 puerperae undergoing cesarean section admitted in our hospital from December 2018 to December 2019 were retrospectively analyzed.According to different nursing methods,the puerperae were divided into reference group and postural intervention group,with 43 cases in each group.After anesthesia,the operation bed was tilted 30°to the left in nursing of the reference group,and the right buttock of puerpera was padded 4-5 cm in nursing of the postural intervention group.Diastolic pressure,systolic pressure,respiratory rate,heart rate before and after 20 min of anesthesia,ephedrine dosage,incidence of adverse events,neonatal Apgar score and puerperae NSNS score were compared between the two groups.Results After 20 min of anesthesia,the diastolic pressure and systolic pressure of the two groups were lower than those before anesthesia,but those in the postural intervention group were significantly higher than the reference group,and the differences were statistically significant(P<0.05);after 20 min of anesthesia,the respiratory rate and heart rate of the two groups were higher than those before anesthesia,but those in the postural intervention group were significantly lower than the reference group,and the differences were statistically significant(P<0.05).The used dosage of ephedrine in the postural intervention group was(5.23±1.05)mg,which was significantly less than(8.14±1.77)mg in the reference group,and the difference was statistically significant(P<0.05).The incidences of intraoperative hypotension syndrome,unilateral block insufficiency and hypoxemia in the postural intervention group were significantly lower than those in the reference group,and the differences were statistically significant(P<0.05).The neonatal Apgar score and puerperae NSNS score in the postural intervention group were significantly higher than those in the reference group,and the differences were statistically significant(P<0.05).Conclusion The special postural intervention on prevention and treatment of SHS in puerperae undergoing cesarean section has significant effect,which is worthy of popularization and application.