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全麻腹部術(shù)后早期半臥位和康復(fù)關(guān)系的探討
摘要：目的：探討全麻腹部術(shù)后早期半臥位和康復(fù)的關(guān)系。方法：隨機將80例全麻腹部手術(shù)患者分為二組，術(shù)后早期分別采取半臥位和平臥位，對術(shù)后各項康復(fù)指標(biāo)進行監(jiān)測和對照。結(jié)果：早期半臥位對全麻腹部手術(shù)后患者在呼吸、循環(huán)、引流、舒適度等方面有明顯的作用。結(jié)論：早期半臥位能全面提高全麻腹部術(shù)后的康復(fù)質(zhì)量。關(guān)鍵詞：全麻腹部手術(shù) 早期半臥位 康復(fù)
The relation between semi-position in early stage and recovery after abdominal operation under general anesthesia Zheng wenya Wang jian.Department of General Surgery, Renji Hospital Affiliated to Shanghai Second Medical University, Shanghai 200001
Abstract: Purpose: To study the relation between semi-position in early stage and recovery after abdominal operation under general anesthesia. Methods: There were eighty consecutive patients in this study who received abdominal operations under general anesthesia. They were classified into two groups in random, who were in semi-position or in supine respectively and were observed through the monitoring and comparison of some post-operative recovery parameters. Results: Semi-position in early stage has positive effect on the patients' respiration, circulation, drainage and comfort etc after abdominal operation under general anesthesia. Conclusion: Semi-position in early stage can improve the quality of recovery after abdominal operation under general anesthesia in some aspects.
Key words: Abdominal operations under general anesthesia Semi-position in early stage Recovery
隨著全身麻醉技術(shù)越來越多的應(yīng)用于腹部手術(shù)，對術(shù)后的康復(fù)質(zhì)量問題也日益受到人們的重視。近年來，我院普外科經(jīng)過臨床實踐觀察，改變了以往全麻腹部術(shù)后常規(guī)去枕平臥六小時的方法，采取早期半臥位，使術(shù)后患者的康復(fù)質(zhì)量得到了改善和提高。同時，進一步證實了早期半臥位對全麻腹部術(shù)后患者在呼吸、循環(huán)、引流、舒適度等方面的積極作用。下面將我們的研究報告如下。
1. 資料與方法
1.1. 臨床資料：選擇1999.9至2000.5全麻腹部手術(shù)患者80例，術(shù)前都無嚴重的心、肺等臟器疾病，年齡25—70歲，平均年齡56.7歲；男性32例，女性48例。其中膽道手術(shù)32例，胃手術(shù)26例，結(jié)直腸手術(shù)17例，門高壓手術(shù)3例，胰腺手術(shù)2例 。
1.2. 方法：隨機將80例患者分為實驗組和對照組，每組40例，二組在年齡、性別、手術(shù)方式上比較沒有差異性。實驗組在患者手術(shù)回到病房后，在生命體征正常，呼之能應(yīng)的情況下即給予半臥位，將床頭逐步搖高到20-450間。對照組給予去枕平臥六小時后采取半臥位。
1.2.1. 呼吸循環(huán)功能指標(biāo)測定：二組患者分別在術(shù)前和術(shù)后六小時測定動脈血氣分析、氧飽和度、血壓（BP）、以及用Micro Medical Lid. US儀測定肺功能指標(biāo)。在術(shù)前各項指標(biāo)正常的情況下，分別收集術(shù)后其中的動脈血二氧花碳分壓（PaCO2）、氧飽和度（SaO2 ）、肺活量（VC）值，肺活量用實測值占預(yù)計正常值的百分比（A/P）來表示。分別統(tǒng)計出在PaCO2
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