關鍵詞：全麻腹部手術 早期半臥位 康復
The relation between semi-position in early stage and recovery after abdominal operation under general anesthesia Zheng wenya Wang rtment 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
隨着全身麻醉技術越來越多的應用於腹部手術，對術後的康復質量問題也日益受到人們的重視。近年來，我院普外科經過臨牀實踐觀察，改變了以往全麻腹部術後常規去枕平臥六小時的方法，採取早期半臥位，使術後患者的'康復質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後患者在呼吸、循環、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. 臨牀資料：選擇1999.9至2000.5全麻腹部手術患者80例，術前都無嚴重的心、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32例，胃手術26例，結直腸手術17例，門高壓手術3例，胰腺手術2例 。
1.2. 方法：隨機將80例患者分爲實驗組和對照組，每組40例，二組在年齡、性別、手術方式上比較沒有差異性。實驗組在患者手術回到病房後，在生命體徵正常，呼之能應的情況下即給予半臥位，將牀頭逐步搖高到20-450間。對照組給予去枕平臥六小時後採取半臥位。
1.2.1. 呼吸循環功能指標測定：二組患者分別在術前和術後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。在術前各項指標正常的情況下，分別收集術後其中的動脈血二氧花碳分壓（PaCO2）、氧飽和度（SaO2 ）、肺活量（VC）值，肺活量用實測值佔預計正常值的百分比（A/P）來表示。分別統計出在PaCO2