The Research On The Proper Upper Body Position, Which Reduce The Old Patients' Blood Pressure Change Best After Taking Lithotomy Position And Other Factors During TUVP

IntroductionLithotomy position can lead to the organ shifting, and gravity effect do more influence to the respiratory system and circulatory system but has little effect on the urinary system. When the position changed, it will lead to the blood redistribution and changing of the venous return. On normal condition body can make blood pressure recuperate in short time by adjusting heart rate , changing peripheral vessel condition and regulating venous return . On anesthesia state putting down legs will keep blood pressure in a low state for a longer time, because muscles can not contract effectually.Study ObjectiveAs a serious study this research want to find out what is the best upper body position for patients who take the TUVP, and what influence the patients'blood pressure most when patients change body position.Study MethodsWe Chose 120 cases according with the request from March 2005 to January 2006 who were took operations in the PLA 463 Hospital and China Medical University affiliated hospital. They have no Phlebitis of lower extremities and serious phlebeurysma , and they were all willing to take part in our research, then theywere under epidural anesthesia, and were randomized in four groups according to the upper body position. Each group has thirty cases. The upper body position were horizontal position^ 10° N 30° and 45°. There were no any interventions to them only to record the variation of blood pressure when they changed position. The dates of ages ^ body weighty the length of operation ^ fluid intake,, and hypertensive disease history and which lithotomy position have been put have been recorded fully. SPSS11. 0 was used for data analysis.Study ResultsResults of contractive pressure and mean arterial blood pressure (MABP) after operation have no great differences expect for putting down the second leg instantly. The positions of the patients'upper body during operation have no relation with the blood pressure change. When putting down the first leg the contractive pressure dropped from 2.7% to 17.3% , and the average was (6.7 ±3. 1) % . The MABP dropped from 3.2% to 16.7% , and the average was( 5.4 ± 3.4)%. When putting down the second leg instantly the contractive pressure dropped from 3. 3% to 20. 5% , and the average was (8. 1 ±4. 5)%. The MABP dropped from 3. 8% to 19. 6% , and the average was(8. 7 ±4. 8)%. Body weighty the length of operation^fluid intake^and hypertensive disease history have influence with the blood pressure when patients change body position after operation. Other factors have no relation with the blood pressure change.Study ConclusionIt will indeed cause blood pressure change a lot when old patients take lithotomy position under TUVP, while the positions of the patients' upper body during operation have no relation with the change. We looked contractive pressure as dependent variable and the relation factors as independent variable. After multifactor stepwise regression analysis we found out that the factors which influenced the blood pressure most were followed by these: the length of operation ^hypertensive disease history^fluid intake^and the body weight.