| Objective:The trauma following thoracotomy for patients with gastric cardiac carcinoma is great, and their postoperative recovery is slow. Semi-recumbent for these patients was conducive to chest drainage and reduce pulmonary and other complications. The study aims to investigate the effects of different implementation methods of semi-recumbent for the patients with thoracotomy in order to seek a safe and comfortable method of position change and provide a theoretical basis for clinical nursing work.Methods: One hundred and five patients with gastric cardiac carcinoma who accepted thoracotomy in a third general hospital in Hebei province from October, 2014 to November, 2015 were randomly divided into three groups, in which patients were respectively given different steps of posture change. Group 1(0°-50° position change): the position were changed from supine position directly semi supine of 50°. Group 2(0°-30°-50° position change): the position were changed from supine position of 0° to semi supine of 30°, then changed to 50° position after 10 minutes. Group 3(0°-15°-30°-50° position change): the position were changed from supine position of 0° to semi supine of 15°, then to 30° after 10 minutes, and to 50° position after another 10 minutes. The changes of the indicators such as body temperature, pulse, respiration, blood oxygen saturation, blood pressure, nausea, and pain level were observed. Datas such as temperature,pulse, respiration, blood oxygen saturation, blood pressure were recorded by the ECG monitor model MFC2000. Whether nausea developed were asked and pain level evaluated by the pain of digital evaluation of international general scale(numerical rating scale,NRS). Data were analyzed using SPSS17.0 statistics software.Results:1 There was no statistical difference in the basic characteristics such as age(P=0.638), sex(P=0.765), operation time(P= 0.081)among the three groups. 2 The changes of the indicators were compared within each group. 2.1 In group 1, there was no statistical difference in body temperature(P=0.190), the existence of nausea(P=0.690), pain level(P=0.847).There were statistically significant in pulse(P=0.014), respiration(P=0.001), systolic blood pressure(P=0.003),diastolic blood pressure(P=0.000)and oxygen saturation(P=0.000). 2.2 In group 2, there was no statistical difference in body temperature(P=0.759), pulse(P=0.592), respiration(P=0.289), systolic blood pressure(P=0.539), diastolic blood pressure(P=0.570), the existence of nausea(P=0.690), pain level(P=0.853)and oxygen saturation(P=0.256)while the position change. 2.3 In group 3, there was no statistical difference in body temperature(P=0.265), pulse(P=0.129), respiration(P=0.773), systolic blood pressure(P=0.917), diastolic blood pressure(P=0.772),the existence of nausea(P=0.643), pain level(P=0.912)and oxygen saturation(P=0.422)while the position change. 3 The indicators of patients in supine position were compared among three groups. While all patients were in supine position, there was no significant differences in body temperature(P=0.971), pulse(P=0.925), respiration(P=0.267), systolic blood pressure(P=0.659)and diastolic blood pressure(P=0.869), the existence of nausea(P=0.895), pain level(P=0.768),oxygen saturation(P=0.818)among three groups. 4 The indicators of patients in semi supine of 50° were compared among three groups. 4.1 While all patients were in semi supine of 50°, there was no significant differences in body temperature(P=0.610), the existence of nausea(P=0.694), pain level(P=0.850)among three groups. 4.2 There was statistically difference in pulse(P=0.028), respiratory rate(P=0.000), systolic blood pressure( P=0.022), diastolic blood pressure(P=0.000), oxygen saturation(P=0.000)between the group 1 and group 2. 4.3 There was statistically difference in pulse(P=0.007), respiratory rate(P=0.002), systolic blood pressure(P=0.021), diastolic blood pressure(P=0.000), oxygen saturation(P=0.000)between the group 1 and group 3. 4.4 There was no statistically difference in pulse(P=0.609), respiratory rate(P=0.521), systolic blood pressure(P=0.990), diastolic blood pressure(P=0.832), oxygen saturation(P=0.687)between the group 2 and group 3. 5 The indicators of patients in semi supine of 30° were compared between group 2 and group 3. In the semi supine of 30°, there was statistically difference in pulse(P=0.003), respiratory rate(P=0.006), systolic blood pressure(P=0.042), diastolic blood pressure(P=0.021), oxygen saturation(P=0.000) between the group 2 and group 3.Conclusion: Position change for patients with gastric cardiac carcinoma following thoracotomy can affect the function of respiratory and circulatory system obviously. When semi-recumbent position change were performed for these patient, the method of 0°-15°-30°-50° position change has the least impact on pulse,respiration,systolic blood pressure diastolic blood pressure and oxygen saturation,and maintain the balance of vital signs and improve the comfort of patients. |
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