护理干预缓解产妇椎管内麻醉术后头痛的疗效观察(1)
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[摘要] 目的:比较观察护理干预缓解产妇椎管内麻醉术后头痛的疗效。方法:选择60例择期行剖宫产的孕妇,麻醉后出现头痛症状,将其随机分为对照组和观察组,对照组按照常规护理,观察组在常规护理的基础上增加硬膜外注入0.9%NaCl溶液、腹部加压、心理干预等护理措施。观察记录两组孕妇的视觉模拟评分法(VAS)评分及其他并发症发生情况。结果:两组术后回病房即刻(T1)和术后12 h(T2)VAS评分差异无统计学意义(P>0.05),对照组术后24(T3)、48(T4)及72 h(T5)VAS评分高于观察组(P<0.05),对照组头昏发生率高于观察组(P<0.05),其他并发症两组差异无统计学意义(P>0.05)。结论:积极的护理干预能减轻术后头痛程度,促进恢复,具有临床实用价值。
[关键词] 椎管内麻醉;头痛;护理;产妇
[中图分类号] R473.71 [文献标识码]C [文章编号]1674-4721(2010)05(c)-105-02
Observation of nursing intervention to release headache after intraspinal anesthesia of puerperas
XIANG Liling,WANG Yingchun,ZHOU Xian,YANG Jiali
(Department of Obstetrics and Gynecology,Maternal and Child Health Hospital of Huaihua, Hunan Province,Huaihua418000 ,China)
[Abstract] Objective:To compare the effect of nursing intervention to release headache after intraspinal anesthesia of puerperas. Methods: 60 cases of selective cesarean with post-dural puncture headache were divided into control group and observe group randomly. Routine nursing was done in control group, while added epidural injection of NS, abdominal compression and mental intervention in observe group. Observed VAS score and other adverse effects occurrence. Results:There were no differences between two groups of T1 and T2 VAS scores(P>0.05), T3-T5 VAS scores of control group were higher than those of observe group, dizziness incidence of control group was also higher than that of observe group, There were no differences between two groups of other adverse effects. Conclusion:Active nursing intervention can release post-dural puncture headache and promote recovery, this nursing method is clinically valuable.
[Key words] Intraspinal anesthesia;Post-dural puncture headache(PDPH);Nursing;Puerpera
椎管内麻醉包括硬膜外阻滞及蛛网膜下腔阻滞,由于其安全有效、对胎儿影响小以及便于术后镇痛等优点,被广泛用作产科手术的首选麻醉方式。硬脊膜穿刺后头痛(post-dural puncture headache,PDPH)是麻醉后较为常见的并发症之一,患者主要表现为头痛,以枕部最明显,平卧位能缓解。围生期解剖及生理特点决定了产妇是PDPH的高发群体,如何应对PDPH是产科护理人员面临的难题,本研究通过对发生头痛的产妇加强护理措施,比较护理对头痛的缓解效果,现报道如下:
1 资料与方法
1.1 一般资料
选取2007年5月～2009年5月于本院产科行择期剖宫产产妇60例,既往及妊娠以来无重要器官疾病史,无头昏头痛史、重大精神疾病史、血管疾病史及长期服药史,手术过程顺利且均生产单胎健康婴儿,术后行硬膜外自控镇痛(PCEA),椎管内麻醉后均出现头枕部疼痛症状,将其随机分成对照组和观察组,每组各30例 ......
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