改良截石位预防腹腔镜全子宫切除术中下肢深静脉血栓的研究  

Effect of the modified lithotomy position on prevention of lower extremity deep ve-nous thrombosis in patients with laparoscopic panhysterectomy

作　　者：朱琳[1] 陈君华[1] 李莉[1] 廖满凤[1] 麦爱贞[1] 

机构地区：[1]南方医科大学附属深圳宝安医院,518101

出　　处：《国际护理学杂志》2015年第22期3041-3043,共3页international journal of nursing

摘　　要：目的：探讨改良截石位对预防腹腔镜全子宫切除术中下肢深静脉血栓（ DⅤT）的影响。方法将168例截石位下腹腔镜全子宫切除术患者随机分为观察组与对照组（各84例）。观察组采用改良截石位施行手术,即先将搁腿板调整为远高近低,将小腿（腓肠肌）中上段搁至搁腿板上,使踝关节高于膝关节6-8 cm,用弹力绷带束缚足部1/2至膝上6 cm 处；对照组采用传统截石位。观察两组患者截石位期间趾、指血氧饱和度（ SpO2）,血浆血栓前体蛋白（ TpP）的变化及术后下肢情况。结果两组患者截石位安置后血浆TpP均有所上升,不同时刻比较,对照组均明显高于观察组（ P〈0.01）；术中对照组趾SpO2异常发生率（15.48%）明显高于观察组（2.38%）（P〈0.01）；术后对照组DⅤT发生率（9.52%）明显高于观察组（1.19%）（P〈0.05）。结论改良式截石位能减轻腹腔镜全子宫切除术患者术中下肢静脉血流瘀滞,减少DⅤT的发生。Objective To explore the effects of modified lithotomy position on prevention of lower extremity deep venous thrombosis （ DⅤT） in patients with laparoscopic panhysterectomy. Methods A total of 168 patients with laparoscopic panhysterectomy undergoing lithotomy position were randomly divided into observation group （ n=84 ） and control group （ n=84 ） . Patients in the observation group were placed with modified lithitomy position： the tail end of the leg-holding plates were adjusted higher and the upper portions of the calf muscle of the patients were placed on the plates so that their ankles were made 6-8 cm higher above knees. The range from 1/2 of feet to 6 cm upper knees were bound with the elastic bandage. The control group was adopt traditional lithotomy position with their lower legs placed on the leg-holding plate and the knees flexed naturally. The degrees of blood oxygen saturation （ SpO2 ） , plasma thrombus precursor protein （ TpP） and the variations of postoperative lower extremity were observed in the two groups during the implementation of lithotomy position. Results The degrees of plasma TpP were all increased in the two groups after the implementation of lithotomy position. The TpP of control group was significantly higher than that of observation group at different time （ P〈0. 01 ） . The abnormal rate of the SpO2 in toes of observation group （ 15. 48%） was significantly higher than that of control group （2. 38%） （P〈0. 01） . The incidence of DⅤT in control group （9. 52%） was signifi- cantly higher than that in observation group （1. 19%） （P〈0. 05） . Conclusion Modified lithotomy position can allevi- ate the venous blood stasis of lower extremity and reduce the incidence of DⅤT in patients with laparoscopic panhysterec- tomy.

关 键 词：腹腔镜手术 全子宫切除术 截石位 深静脉血栓 护理 

分 类 号：R473.71[医药卫生—护理学]