RESUMEN
Postural treatment for acute cerebral infarction involves supine position,lateral position and head elevation.In recent decades,controversy arises concerning determination between supine position and head elevation.Head elevation may decrease intracranial pressure and reduce incidence of pneumonia while supine position may strengthen cerebral perfusion and improve oxygenation indexes in the infarction area to promote recanalization.There has been no clear clinical evidence to determine the best treatment or rehabilitation position for patients with acute cerebral infarction.This article,hoping to provide references for clinical choice of treatment position,reviews the concept ofpostural treatment for patients with acute anterior circulation infarction,impacts of position on cerebral blood flow,arterial oxygen saturation,intracranial pressure and incidence of pneumonia,and possible ways of the impacts as well.
RESUMEN
Objective To evaluate the accuracy of head-of-bed elevation in postoperative lung cancer patients, in order to identify the compliance of patients and nurses, and to decrease the postoperative complications and restore rehabilitation. Methods 300 postoperative lung cancer patients were divided into two groups (150 patients in experimental group and 150 patients in control group) by random digital table method. The head of the beds were elevated according to the marking sign on the intravenous infusion stand in experimental group, whereas in control group nurses elevating the bed to the height that patients felt comfortable. The compliance of patients and nurses, the indwelling time of thoracic drainage tube, postoperative complication, and the length of hospital stay were recorded and analyzed. Results The compliance of nurses and patients in the experimental group were 98.7% (148/150) and 95.3% (143/150), respectively, compared to 93.3% (140/150) and 87.3% (131/150) in the control group (X2=5.56, 6.06, P<0.05). Significant difference was found in indwelling time of thoracic drainage tube between the experimental group [(96.0±27.8) h] and the control group [(103.1±24.1) h] . The length of hospital stay in experimental group was (7.9±2.1) d, compared with (8.4±2.2) d in control group (t=-2.45,-1.99, P<0.05). There was significant difference in postoperative complications between experimental group [12.0% (18/150)] and control group [20.7% (31/150)]( X2=4.12,P<0.05). Conclusions Evaluating the head of the bed accurately by the marking sign on intravenous infusion stand stand can promote the postoperative care outcome of lung cancer patients, decrease the postoperative complications and restore rehabilitation.
RESUMEN
Intracranial pressure was monitored in 23 patients, either who exhibited an increase in pressure or who were considered at risk for the developement of intracranial hypertention. The intracranial pressure was measured while the patient was in the position from supine to 50 degree of head elevation. The intracranial pressure was decreased during head elevation, but 8 cases(34.8%) were not changed. The maximal cerebral perfusion pressure was seen at 50 degree of head elevation(52.2%), next 30 degree(21.7%) and 40 degree(7.4%) in orders. The changes of vital sign were not significant during head elevation. To control the intracranial pressure, the patient who were managed in the position of 30degrees and 50degrees head elevation showed most effective cerebral perfusion pressure without any significant changes of the vital sign and central venous pressure.