甲状腺手术患者体位摆放法的改良  

Improvement of the Posture of Patients Undergoing Thyroid Surgery

作　　者：沈秋月[1] 

机构地区：[1]嵊州市人民医院手术室,浙江嵊州312400

出　　处：《解放军护理杂志》2015年第2期67-68,共2页Nursing Journal of Chinese People's Liberation Army

摘　　要：目的探讨甲状腺手术患者体位摆放的改良方法。方法便利抽样法选取2013年8月至2014年3月,在嵊州市人民医院手术室实施甲状腺手术患者100例为研究对象,按入院时间先后,将其分为对照组和观察组,每组50例。对照组患者手术体位摆放时应用体位垫,而观察组患者不采用体位垫,而是通过调整手术床进行体位摆放。比较两组患者体位摆放时间、效果、麻醉安全及患者术后48h的舒适度。结果观察组患者体位摆放时间为(0.98±0.18)min,短于对照组的(2.03±0.23)min,差异有统计学意义(t=25.81,P<0.01)。两组手术体位摆放后手术部位均暴露良好,两组手术医生对手术部位暴露均满意。对照组出现呼吸道导管滑脱2例、动脉导管脱开1例、心电极线与电片脱离3例,而观察组未出现上述现象。观察组患者术后疼痛数字评分法(numerical rating scale,NRS)疼痛平均评分为(0.28±0.78)分,低于对照组的(1.40±2.04)分,差异有统计学意义(t=3.620,P<0.05)。结论改良甲状腺手术患者体位的摆放方法明显优于传统甲状腺手术体位摆放,值得推广。Objective To discuss the improvement method of the appropriate patients posture in thyroid surgery. Methods By convenience sampling, 100 patients were selected and equally divided into control group and observation group according to the admission time. The patients in control group were using position pad while the observation group adjusted the operation bed instead. Posturing speeds, effect, anesthesia safety and 48 hours postoperative comfort level were compared between two groups. Results The posture time of patients in observation group was （0.98±0.18）min, which was shorter than control group of （2.03±0.23）min, and the difference was statistically significant （t=25.81, P〈0.01）. Surgery exposures were fine in both groups and the doctors in both groups were satisfied with the exposure. Control group had 2 cases of breathing tube dropping, 1 case of arterial duct release, and 3 cases of heart electrode wire and electrical sheet isolation, while the observation group had none of the above accident. The postoperative NRS pain average score was （0.28±0.78）, which was lower than control group of （1.40±2.04）,and the difference was statistically significant （t=3.620,P〈0.05）. Conclusion Improved patients posture method in thyroid surgery is significantly better than traditional operative posture, and it is worthwhile for clinical trial.

关 键 词：无体位垫 甲状腺手术体位 效果观察 

分 类 号：R472.3[医药卫生—护理学]