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外文摘要
引文資料
題名:
比較早期改變臥位與手術後平躺六小時其硬脊膜穿刺後頭痛的發生率--以採脊髓麻醉之腹股溝疝氣手術病人為例
書刊名:
榮總護理
作者:
林小玲
/
王麗玲
/
謝雅宜
/
連金延
/
石宜銘
/
鄒樂起
作者(外文):
Lin, Shirling
/
Wang, Lin-ling
/
Hsieh, Ya-i
/
Lien, Chin-yen
/
Shyr, Yi-ming
/
Chow, Lok-hi
出版日期:
2018
卷期:
35:2
頁次:
頁112-125
主題關鍵詞:
硬脊膜穿刺後頭痛
;
早期改變臥位
;
脊髓麻醉
;
腹股溝疝氣手術病人
;
實證照護
;
Postdural puncture headache
;
Early ambulation
;
Spinal anesthesia
;
Inguinal herniaplasty
;
Evidence-based practice
原始連結:
連回原系統網址
相關次數:
被引用次數:期刊(0) 博士論文(0) 專書(0) 專書論文(0)
排除自我引用:0
共同引用:0
點閱:0
半身麻醉病人接受脊髓麻醉後為預防硬脊膜穿刺後頭痛,通常要求手術後病人平躺6-8小時,然往往使病人有腰酸背痛和解尿困難的情形,本研究目的為比較手術後早期改變臥位其硬脊膜穿刺後頭痛的差異。研究採三組多時間序列前後測之類實驗性設計,研究對象為台北某醫學中心一般外科病房因腹股溝疝氣接受疝氣修補術且採半身麻醉之病人。對照組依傳統手術返室後平躺6小時,實驗A組為手術返室後平躺4小時,實驗B組為手術返病室後即可隨意活動。以廣義估計方程式(Generalized Estimation Equation, GEE)分析不同組別時間序列發生頭痛及相關症狀之差異。主要結果:(一)三組病人發生症狀最多者,依序為腰酸背痛(48%)、頭暈(16%)與解尿困難(11%);(二)硬脊膜穿刺後頭痛發生率為3%,三組病人頭痛發生率之差異無顯著;三組病人於手術前、術後返室6小時臥床期間及術後七天監測,頭痛發生率之差異無統計顯著差異;(三)對照組腰酸背痛發生率(59%)比實驗B組(30%)高,此差異達顯著;對照組於術後返室時至第6小時腰痠背痛分數逐漸增加,實驗A、B組每個背痛觀察點疼痛分數皆低於對照組。本研究依實證照護應用,建立本土具文化背景的照護常規,結果可作為一般外科病房護理人員針對脊髓麻醉的腹股溝疝氣手術後病人,執行手術後早期改變臥位時的依據,降低脊髓麻醉後平躺導致背痛相關症狀,確保病人獲得完善的照護。
以文找文
Background: To prevent postdural puncture headache (PDPH) following spinal anesthesia, postsurgery patients may be advised to lie flat for 6–8 hours. This supine recumbence can result in back pain or dysuria throughout patients' recovery from anesthesia. Objective: To compare the incidence of PDPH between early ambulation and 6-hour supine recumbence groups and to investigate the effectiveness of early ambulation intervention in postspinal anesthesia inguinal herniaplasty patients. Methods: A 3-group time series before-after quasi-experimental design was used. A 6-hour recumbent group, 4-hour recumbent group, and early ambulation group were recruited. The generalized estimation equation of PDPH and backache from the three groups was computed and analyzed. Results: The most common syndromes after surgery were back pain (48%), fainting (16%), and dysuria (11%). No statistically significant differences in the prevalence of PDPH were determined among the 3 groups in the 7-day study period. A significant difference was noted in the prevalence of back pain among the 3 groups. Conclusions: On the basis of the study findings, early ambulation after spinal anesthesia care routine for patients with inguinal herniaplasty should be developed to examine the appropriateness of applying an early ambulation intervention. Furthermore, expanding early ambulation interventions to other spinal anesthesia surgery patients is recommended to improve the quality of postsurgical care for patients in general surgical care units.
以文找文
期刊論文
1.
Bezov, D.、Ashina, S.、Lipton, R.(2010)。Post-dural puncture headache. Part II-prevention, management, and prognosis。Headache: The Journal of Head and Face Pain,50(9),1482-1498。
2.
Amorim, J. A.、Gomes de Barros, M. V.、Valenca, M. M.(2012)。Postdural (post-lumbar) puncture headache: risk factors and clinical features。Cephalalgia,32(12),916-923。
3.
Arevalo‐Rodriguez, I.、Ciapponi, A.、Roqué I Figuls, M.、Muñoz, L.、Bonfill Cosp, X.(2016)。Posture and fluids for preventing post-dural puncture headache。Cochrane Database of Systematic Reviews,12(7)。
4.
Arevalo‐Rodriguez, I.、Muñoz, L.、Godoy‐Casasbuenas, N.、Ciapponi, A.、Arevalo, J. J.、Boogaard, S.、Roqué I Figuls, M.(2017)。Needle gauge and tip designs for preventing post-dural puncture headache (PDPH)。Cochrane Database of Systematic Reviews,2017(4)。
5.
Bezov, D.、Lipton, R. B.、Ashina, S.(2010)。Post‐Dural Puncture Headache: Part I Diagnosis, Epidemiology, Etiology, and Pathophysiology。Headache: The Journal of Head and Face Pain,50(7),1144-1152。
6.
de Almeida, S. M.、Shumaker, S. D.、LeBlanc, S. K.、Delaney, P.、Marquie‐Beck, J.、Ueland, S.、Ellis, R. J.(2011)。Incidence of Post‐Dural Puncture Headache in Research Volunteers。Headache: The Journal of Head and Face Pain,51(10),1503-1510。
7.
Headache Classification Subcommittee of the International Headache Society(2004)。The international classification of headache disorders。Cephalalgia,24(1),1-160。
8.
Imarengiaye, C.、Ekwere, I.(2006)。Postdural puncture headache: A cross-sectional study of incidence and severity in a new obstetric anaesthesia unit。African Journal of Medicine and Medical Sciences,35(1),47-51。
9.
Kim, S. R.、Chae, H. S.、Yoon, M. J.、Han, J. H.、Cho, K. J.、Chung, S. J.(2012)。No effect of recumbency duration on the occurrence of post-lumbar puncture headache with a 22G cutting needle。BMC Neurology,12(1),1。
10.
Maurer, S. G.、Chen, A. L.、Hiebert, R.、Pereira, G. C.、Di Cesare, P. E.(2007)。Comparison of outcomes of using spinal versus general anesthesia in total hip arthroplasty。The American Journal of Orthopedics,36(7),E101-E106。
11.
McKenzie, P.、Wishart, H.、Gray, I.、Smith, G.(1985)。Effects of anaesthetic technique on deep vein thrombosis: A comparison of subarachnoid and general anaesthesia。British Journal of Anaesthesia,57(9),853-857。
12.
Nath, S.、Koziarz, A.、Badhiwala, J. H.、Alhazzani, W.、Jaeschke, R.、Sharma, S.、Nassiri, F.(2017)。Atraumatic versus conventional lumbar puncture needles: A systematic review and meta-analysis。The Lancet,391(10126),1197-1204。
13.
Park, S.、Kim, K.、Park, M.、Lee, U.、Sim, H. S.、Shin, I. S.、Song, Y.(2017)。Effect of 24-Hour Bed Rest versus Early Ambulation on Headache after Spinal Anesthesia: Systematic Review and Meta-analysis。Pain Management Nursing,19(3),267-276。
14.
Sinikoglu, N. S.、Yeter, H.、Gumus, F.、Belli, E.、Alagol, A.、Turan, N.(2013)。Reinsertion of the stylet does not affect incidence of post dural puncture headaches (PDPH) after spinal anesthesia。Revista Brasileira de Anes tes iologia,63(2),188-192。
15.
Sudlow, C.、Warlow, C.(2009)。Posture and fluids for preventing post-dural puncture headache。Cochrane Database of Systematic Reviews,2。
16.
Tejavanija, S.、Sithinamsuwan, P.、Sithinamsuwan, N.、Nidhinandana, S.、Suwantamee, J.(2006)。Comparison of prevalence of post-dural puncture headache between six hour-supine recumbence and early ambulation after lumbar puncture in thai patients: A randomized controlled study。Journal Medical Association of Thailand,89(6),814。
17.
Turnbull, D.、Shepherd, D.(2003)。Postdural puncture headache: Pathogenesis, prevention and treatment。British Journal of Anaesthesia,91(5),718-729。
18.
van Oosterhout, W.、van der Plas, A.、van Zwet, E.、Zielman, R.、Ferrari, M.、Terwindt, G.(2013)。Postdural puncture headache in migraineurs and nonheadache subjects A prospective study。Neurology,80(10),941-948。
19.
Waise, S.、Gannon, D.(2013)。Reducing the incidence of post-dural puncture headache。Clinical Medicine,13(1),32-34。
學位論文
1.
宋芳齡(2009)。術後枕部高度對脊膜穿刺麻醉後頭痛之影響(碩士論文)。臺北醫學大學。
延伸查詢
圖書
1.
Dawson-Saunders, Beth、Trapp, Robert G.(1990)。Basic and Clinical Biostatistics。Appleton & Lange。
2.
林品村、周昱甫、楊士賢、莊昆隆、賴大維、張尚宏、周宗慶(2000)。臨床麻醉學。台北:合記。
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