摘要
目的探讨改良中凹水平截石位对妇科腔镜手术效果及围术期血压、术后并发症的影响。方法选取2018年1月至2021年1月东台市人民医院妇产科收治的拟行腹腔镜手术的患者108例作为研究对象,按照双色球法分为对照组与研究组,各54例。对照组患者采用人字形分腿体位进行手术,研究组患者采用改良中凹水平截石位进行手术。比较两组患者手术效果、围术期血压、体位舒适度及术后并发症发生情况。结果研究组体位架移位、脱落及术中体位调整、重置次数以及举宫器安装耗时均明显低于对照组,但体位摆放耗时明显长于对照组(均P<0.05);对照组体位摆放后各时间节点血压均较体位摆放前明显变化(P<0.05),但研究组体位改变前后血压差异无统计学意义(P>0.05);相同术式研究组术中出血量少于对照组,手术时间短于对照组(P<0.05);研究组体位舒适性量表中环境、心理、生理维度得分及总分均高于对照组;术后下肢水肿、疼痛以及肩部疼痛发生率均明显低于对照组(均P<0.05)。结论相比于人字形分腿体位,改良中凹水平截石位用于妇科腔镜手术虽摆放时间较长,但可减少术中出血量,缩短手术时间,提高患者体位舒适度,降低术后体位相关性并发症的发生率,对提高手术安全性具有积极的作用。
Objective To analyze the effect of modified foveal level lithotomy position on patients'operative outcomes,perioperative blood pressure and postoperative complications in gynecologic endoscopic surgery.Methods A total of 108 consecutive patients who would undergo gynecological laparoscopic surgery in the Department of Obstetrics and Gynecology of Dongtai People's Hospital from January 2018 to January 2021 were divided into control group(n=54)and study group(n=54)according to the bichromatic ball method,54 patients were operated with a spica shaped split leg position in the control group,and 54 patients were operated with a modified foveal level lithotomy position in the study group,the surgical effects,perioperative blood pressure,and body position comfort and postoperative complications were compared between the two groups.Results The frequency of postural frame changed or fell off,intraoperative posture adjustment,reset time and uterine lift installation time were significantly lower in the study group than the control group,but the time of posture placement was significantly longer than the control group(all P<0.05).The blood pressure was significantly changed at each time after the position was placed in the control group(P<0.05),while the blood pressure has no significant changed in the study group(P>0.05);The intraoperative blood loss was less in the study group than the control group,and the operation time was shorter than the control group too(P<0.05).The total score and each dimension score of physical comfort environment and psychophysiological dimensions were higher in the study group than the control group,the edema and pain of lower limb,shoulder pain were significantly lower in the study group than the control group(all P<0.05).Conclusions The placed position time was longer in the foveal horizontal lithotomy position than the spica split leg position in gynecologic endoscopic surgery,but the foveal horizontal lithotomy position can reduce intraoperative blood loss,shorten the length of surgery,improve patients comfort,reduce the incidence of complications,and have a positive effect on the improvement of surgical safety.
作者
胡燕华
姜秋蓉
周林
吕亚
HU Yanhua;JIANG Qiurong;ZHOU Lin;LYU Ya(Department of Operating Room, Dongtai People's Hospital, Dongtai 224200, China;Gynecology Department, Wuxi Maternal and Child Health Hospital, Wuxi 214000, China)
出处
《医药高职教育与现代护理》
2021年第6期502-506,共5页
Medical Higher Vocational Education and Modern Nursing
基金
无锡市卫计委科研面上项目(MS201834)。
关键词
改良中凹水平截石位
妇科
腔镜手术
围术期血压
体位
舒适度
Modified foveal horizontal lithotomy
Gynecology
Endoscopic surgery
Perioperative blood pressure
Position
Comfort
