不同倾斜度体位对腹腔镜全子宫切除患者眼内压和术后舒适度的影响  

Influence of different tilt positions for laparoscopic hysterectomy on intraocular pressure and postoperative comfort of patients

作　　者：李晓芬[1] 樊理华[2] 韩蔚[3] 应秀华[3] 郑红枫[4] 吴伯乐[5] 徐巧敏[2] 曾凤美[1] 艾梦婷[1] 刘慧巧[5] 

机构地区：[1]浙江省丽水市人民医院手术室,323000 [2]浙江省丽水市人民医院麻醉科,323000 [3]浙江省丽水市人民医院护理部,323000 [4]浙江省丽水市人民医院妇产科,323000 [5]浙江省丽水市人民医院眼科,323000

出　　处：《中华现代护理杂志》2014年第34期4312-4314,共3页Chinese Journal of Modern Nursing

基　　金：丽水市公益性技术应用项目（2012JYZB69）

摘　　要：目的：观察不同倾斜度头低臀高位对腹腔镜全子宫切除患者眼内压和术后舒适度的影响。方法选择80例妇科腹腔镜手术患者作为研究对象，均为美国麻醉协会（ ASA）麻醉分级Ⅰ级。按随机数字表法将患者随机分为头低位15＆#176;组和头低位30°组，每组40例。监测患者基础眼内压（ T0）、气腹并改变体位后30 min（ T1）、60 min（ T2）和气腹结束后10 min（ T3）时的眼内压。24 h内随访患者，询问患者术后舒适度。结果头低位15°组患者T1、T2时眼内压分别为（18．16±2．16），（19．60±2．18）mmHg，分别低于头低位30°组的（19．21±2．17）与（20．87±2．17）mmHg，差异有统计学意义（t值分别为2．1689，2．6113；P＜0．05）。头低位15℃;组患者术后眼部不适、肩痛的发生率分别为2．5％，7．5％，分别低于头低位30°组的20．0％，25．0％，差异有统计学意义（χ2值分别为4．5075，4．5006；P＜0．05）。两组恶心、呕吐和小腿疼痛的发生率比较，差异无统计学意义（χ2值分别为0．2381，0．0000；P＞0．05）。结论妇科腹腔镜手术15°头低位比30°头低位对患者眼内压影响更小，术后舒适度更高。Objective To observe the influence of different tilt positions for laparoscopic hysterectomy on intraocular pressure and patients’ postoperative comfort.Methods Totals of 80 patients with laparoscopic＆amp;nbsp;surgery ℃with grade-I anesthesia （ American Society of Anesthesiologists, ASA） were chosen and divided into group A（15°T） and group B （30°T） by using the random table methods, with 40 cases in each.Intraocular pressure of patients at baseline （ T0 ） , 30 minutes （ T1 ） and 60 minutes （ T2 ） of pneumoperitoneum and after changing the position, and 10 minutes after pneumoperitoneum were monitored.The follow-up of the patients was within 24 hours asking the comfort of them.Results The intraocular pressure of patients at T1 and T2 in group A were （18.16 ±2.16） and （19.60 ±2.18） mmHg, which were significantly lower than group B [（19.21 ± 2.17） and （20.87 ±2.17） mmHg] （t =2.168 9, 2.611 3, respectively;P ＆lt;0.05）.The incidences of postoperative ocular discomfort and back pain in group A were 2.5% and 7.5%, respectively, which were significantly lower than group B （20.0%, 25.0%） （χ2 =4.507 5, 4.500 6, respectively;P〈0.05）.The incidences of nausea, vomiting, and leg pain had no significant differences （χ2 =0.238 1, 0.000 0, respectively;P〈0.05）.Conclusions 15℃;head-down position laparoscopic surgery has less effect on the patient’ s intraocular pressure than 30℃;head-down position laparoscopic surgery, besides, patients have more comfort.

关 键 词：头低位 腹腔镜 子宫切除术 眼内压 倾斜度 舒适度 

分 类 号：R473.71[医药卫生—护理学]