Kocaeli Vocational School of Health Services, Kocaeli University, Kocaeli, Turkey.
School of Nursing, Florence Nightingale Nursing Faculty, Istanbul University, Istanbul, Turkey.
J Clin Nurs. 2019 Apr;28(7-8):1135-1147. doi: 10.1111/jocn.14704. Epub 2018 Nov 22.
To determine the effect of position change that is applied after percutaneous coronary intervention on vital signs, back pain and vascular complications.
In order to minimise the postprocedural complications, patients are restricted to prolonged bed rest that is always accompanied by back pain and haemodynamic instability.
Randomised-controlled quasi-experimental study.
The study sample chosen for this study included 200 patients who visited a hospital in Turkey between July 2014-November 2014. Patients were divided into two groups by randomisation. Patients in the control group (CG, n = 100) were put in a supine position, in which the head of the bed (HOB) was elevated to 15°, the patient's leg on the side of the intervention was kept straight and immobile; positional change was applied to patients in the experimental group (EG, n = 100).
After the procedure in the EG, the systolic blood pressure (T4-T6), the rate of postprocedural vascular complications (1%) and the back pain scores were significantly lower (between T5-T6) than the CG, also, the back pain was the lowest level in the standard fowler's position in the 6th hr wherein the HOB was elevated by 45-60°.
It was found that systolic blood pressure and back pain were at the lowest levels in the standard fowler's position in the 6th hr after the procedure when the HOB was elevated 45-60° and the result was clinically significant and the position change decreased back pain without causing any vascular complications.
Low fowler's position was applied in which HOB was elevated 15-30° and standard fowler's position was applied in which the HOB was elevated 45-60° could be safe and applicable in patients by nurses after the procedure.
确定经皮冠状动脉介入治疗后体位改变对生命体征、背痛和血管并发症的影响。
为了尽量减少术后并发症，患者需要长时间卧床休息，这往往伴随着背痛和血液动力学不稳定。
随机对照准实验研究。
本研究选择了 200 名 2014 年 7 月至 11 月期间在土耳其一家医院就诊的患者。通过随机分组将患者分为两组。对照组（CG，n=100）患者采用仰卧位，床头抬高 15°，介入侧腿部伸直不动；实验组（EG，n=100）患者采用体位改变。
EG 组患者在手术后，收缩压（T4-T6）、术后血管并发症发生率（1%）和背痛评分明显低于 CG 组（T5-T6 期间），并且在第 6 小时采用标准弗洛勒斯卧位时，背痛最低（床头抬高 45-60°）。
研究发现，术后第 6 小时，床头抬高 45-60°，采用标准弗洛勒斯卧位时，收缩压和背痛最低，结果具有临床意义，体位改变可减轻背痛，且不会引起任何血管并发症。
护士可在术后为患者应用低弗洛勒斯卧位（床头抬高 15-30°）和标准弗洛勒斯卧位（床头抬高 45-60°），这种方法安全且适用。
