【作者】 王方；

【导师】 苏兰若；

【作者基本信息】 中国医科大学 ， 护理学， 2010， 硕士

【摘要】 目的探讨实施下肢被动运动和医用弹力绷带两种护理干预措施对老年截石位手术患者放平下肢后血压、心率等指标的影响,并比较两种方法预防截石位体位改变性低血压的有效性。方法选取2009年2～9月期间在中国医科大学附属第一临床医院手术室行经尿道前列腺电切术(TURP)的老年患者90例,随机分为观察1组、观察2组和对照组各30例。手术结束后所有患者均采用单腿慢放,其中观察1组实施下肢被动运动；观察2组应用医用弹力绷带；对照组未实施护理干预。记录三组患者术毕放平下肢前(截石位)、放平一侧下肢即刻、放平双下肢即刻、放平双下肢1、3、5min时的血压、心率。结果被动运动组和弹力绷带组患者血压维持稳定,体位改变前后收缩压(SBP)、平均动脉压(MAP)无明显变化(P>0.05),且两组之间比较无显著性差异(P>0.05)；对照组患者放平下肢后SBP、MAP明显降低,与体位改变前及被动运动组和弹力绷带组比较均显著下降(P<0.01或P<0.05)；三组患者心率(HR)均出现增快(P<0.01或P<0.05)。结论实施下肢被动运动和医用弹力绷带两种护理干预措施,均可减轻老年截石位手术患者血压的波动程度,对预防截石位体位改变性低血压,保证患者围手术期安全有一定的实际意义。更多还原

【Abstract】 ObjectiveTo explore the influence of two different nursing interventions on blood pressure of elderly patients undergoing lithotomy position surgery. And to compare the effectiveness of two methods to prevent hypothension when position change.Method90 cases of gerontal patient treated by transurethral resection of prostate(TURP) from February 2009 to September in the fist hospital of China Medical University were randomly divided into the observation group 1, observation group 2, and control group with 30 patients in each. After surgery all patients were using one leg slow-release. In which observation group 1 implementation of the lower limb passive movement, observation group 2 applied medical elastic bandage, and the control group with no intervention. The blood pressure and heart rate of all patients at different time points were recorded. The time points including before flat lower extremities(lithotomy postion), flat side of the lower extremities immediately, flat lower extremities immediately, flat lower limbs 1、3、5min.ResultsPassive motion group and the elastic bandage group blood pressure remained stable. The systolic blood pressure(SBP), mean arterial pressure(MAP) with no significant change before and after the postural change (P>0.05).The blood pressure decreased significantly in control group compared with the before postural change level and passive motion group and the elastic bandage group (P<0.01或P<0.05); three groups of patients increased heart rate fast (P<0.01或P<0.05)ConclusionImplementation of the lower limb passive movement and medical elastic bandage can help to maintain the blood pressure in a normal level in elderly patients during lithotomy position surgery. Thus can prevent orthostatic hypotension and ensure the safety of patients in the perioperative period with a certain degree of practical significance.更多还原