摘要
目的:研究不同体位对腹腔镜胆囊切除术(LC)病人麻醉恢复期呼吸及舒适度的影响。方法:采用便利抽样法选取2022年1月-10月在西南医科大学附属医院行腹腔镜胆囊切除术的236例病人,随机分为A组(去枕平卧位)、B组(15°半卧位)、C组(30°半卧位)、D组(渐进性半卧位),各59例。比较4组拔除喉罩2 h内的血氧饱和度、呼吸频率、呼气峰流速(PEF)、用力呼气量(FVC)、第1秒用力呼气量(FEV_(1))、FEV_(1)/FVC、最大吸气压(MIP)、最大呼气压(MEP)、呼吸道并发症和舒适度。结果:B组、C组和D组在拔除喉罩1 h和2 h的PEF、FVC、FEV_(1)、MIP、MEP均高于A组(P<0.05);B组、C组和D组在拔除喉罩2 h的FEV_(1)/FVC高于A组(P<0.05);C组在拔除喉罩2 h的MEP高于B组(P<0.05);D组在拔除喉罩2 h的MIP和MEP值高于B组(P<0.05);B组、C组和D组的Kolcaba舒适状况量表评分高于A组(P<0.05);D组Kolcaba舒适状况量表评分高于A组、B组、C组(P<0.05);4组血氧饱和度、呼吸频率、呼吸道并发症发生率、心率、血压、平均动脉压、体温、疼痛程度、清醒程度比较,差异无统计学意义(P>0.05)。结论:腹腔镜胆囊切除术病人拔除喉罩后取15°半卧、30°半卧、渐进性半卧均利于病人肺通气和呼吸力学效应,且舒适度更好。其中30°半卧和渐进性半卧更利于呼吸肌做功,渐进性半卧舒适度最佳。
Objective:To explore the influence of different postures on the patient's breathing and comfort during anesthesia recovery after laparoscopic cholecystectomy were studied.Methods:A total of 236 patients who undergoing laparoscopic cholecystectomy(LC)were selected by convenience sampling.We divided the patients into four groups:group A(supine),group B(15°semi-recumbent),group C(30°semi-recumbent)and group D(progressive semi-recumbent)randomly,59 cases in each group.Patients'SPO2,RR,Peak expiratory flow rate(PEF),forced expiratory volume(FVC),forced expiratory volume in one second(FEV_(1)),FEV_(1)/FVC,maximum inspiratory pressure(MIP),maximum expiratory pressure(MEP),respiratory complications,comfort was compared among four groups.Results:The values of PEF,FVC,FEV1,MIP and MEP in group B,C and D at 1 hour and 2 hours after the laryngeal mask was removed were higher than A group(P<0.05).FEV1/FVC of group B,group C and group D were higher than supine group at 2 hours after the laryngeal mask was removed(P<0.05).The MEP value of group C was higher than group B at 2 hours after the laryngeal mask was removed.The MIP and MEP values of the group D were higher than group B at 2 hours after the laryngeal mask was removed(P<0.05).Kolcaba Comfort scores of group B,group C and group D were higher than group A(P<0.05).The score of Kolcaba Comfort Scale in group D was higher than that in group A,B and C(P<0.05).There was no statistical significance in SPO2,RR,respiratory complications,blood pressure,mean arterial pressure,body temperature,pain level,level of wakefulness between the four groups(P>0.05).Conclusion:15°semi-supine position,30°semi-supine position and progressive semi-supine position after laryngeal mask removal after LC is conducive to lung ventilation and respiratory mechanical effect,and can obtain better comfort.The 30°semi-decubitus position and progressive semi-decubitus position are most conducive to the work of respiratory muscle,and the comfort of progressive semi-supine position is the best.
作者
汤灵宇
陈顺利
蔡璐瑶
陈颖异
宋建英
胡黎欣
郑思琳
TANG Lingyu;CHEN Shunli;CAI Luyao;CHEN Yingyi;SONG Jianying;HU Lixin;ZHENG Silin(Affiliated Hospital of Southwest Medical University,Sichuan 646000 China)
出处
《护理研究》
北大核心
2024年第15期2675-2682,共8页
Chinese Nursing Research
关键词
腹腔镜胆囊切除术
麻醉恢复期
体位
呼吸
舒适度
护理
laparoscopic cholecystectomy,LC
anesthesia recovery period
position
breathing
comfort
nursing
作者简介
汤灵宇,护师,硕士研究生在读;通讯作者:郑思琳,E-mail:1400223549@qq.com。
