改良式下床法在腰椎术后患者首次下床中的运用

胡扬　林婷婷　张爱娟　林立宇

【摘要】 目的：通过实行改良式下床法，探索其对腰椎术后患者首次下床预防体位性低血压的效果，预防相关并发症的发生，为促进患者术后康复提供依据。方法：选取2018年10月-2019年10月在笔者所在医院行腰椎手术治疗的100例患者，采用便利抽样的方法，分成护理干预组（50例）及对照组（50例）。对照组采取传统下床护理模式，护理干预组采取改良式下床法护理干预模式，观察两组术后直立性低血压的发生率及护理舒适度。结果：护理干预组直立性低血压发生率为16%，低于对照组的76%，差异有统计学意义（P<0.05）。与对照组比较，护理干预组护理舒适度更高，差异有统计学意义（P<0.05）。结论：通过采取改良式下床法可以降低中老年腰椎术后患者直立性低血压的发生，促进患者早日康复。

【关键词】 腰椎术 体位性低血压 改良式下床法

doi：10.14033/j.cnki.cfmr.2020.21.032 文献标识码 B 文章编号 1674-6805（2020）21-00-03

Application of the Improved Method of Getting out of Bed for the First Time in Patients after Lumbar Surgery/HU Yang， LIN Tingting， ZHANG Aijuan， LIN Liyu. //Chinese and Foreign Medical Research， 2020， 18（21）： -79

[Abstract] Objective： To explore the effect of the improved method of getting out of bed for the first time to prevent postural hypotension， prevent the occurrence of related complications， and provide the basis for promoting the postoperative rehabilitation of patients. Method： From October 2018 to October 2019， 100 patients with lumbar surgery were divided into two groups， nursing intervention group （50 cases） and control group （50 cases）. The control group adopted the traditional out of bed nursing mode， the nursing intervention group adopted the improved method out of bed nursing intervention mode， and observed the incidence of postural hypotension and nursing comfort of the two groups. Result： The incidence of postural hypotension was 16% in the nursing intervention group， which was lower than 76% in the control group， the difference was statistically significant （P<0.05）. Compared with the control group， the nursing comfort of the nursing intervention group was higher， and the difference between the two groups was statistically significant （P<0.05）. Conclusion： The improved method of getting out of bed can reduce the incidence of postural hypotension and promote the early recovery of middle-aged and old patients.

[Key words] Lumbar surgery Postural hypotension Improved method of getting out of bed

First-authors address： Fujian Provincial Hospital， Fuzhou 350001， China

腰椎間盘切除植骨融合术是当前治疗腰椎疾病的常用方法，笔者所在医院目前采用显微镜通道下经椎间孔腰椎融合术，手术切口小，术中出血量少，术后卧床时间较开放手术明显缩短[1]。体位性低血压又称为直立性低血压，特指在病理或生理性损伤因素影响下所致站立时血压明显低于平卧时血压的综合性病征，可引发头晕、视物模糊、平衡失调、周身乏力等临床症状，且当人体平均动脉压下降至脑血流自我调节的限度以下后，则可控增加眩晕或全身癫痫样发作风险，增加患者疾病威胁[2]。有关文献表示，腰椎间盘术后发生体位性低血压的概率高达97.3%[3]。目前对腰椎术后患者首次下床的标准化流程国内外研究均较少。对此，为降低患者腰椎术后体位性低血压发生风险所致二次骨折发生率，笔者所在医院将腰椎术后原有下床法进行改良制作成标准化流程—改良式下床法，本研究旨在通过改良式下床法在腰椎术后患者首次下床中预防体位性低血压的应用效果评价，现报告如下。……