不同角度的头低臀高截石位对妇科宫腹腔镜手术患者的影响  

The influence on gynecological laparoscopy surgery patient by head-low and buttocks-high lithotomy position with different angles

作　　者：彭顺平[1] 张莉[1] 王霞[1] 刘蔚[1] 

机构地区：[1]江苏省徐州市妇幼保健院手术室,徐州市221009

出　　处：《护理实践与研究》2016年第8期83-85,共3页Nursing Practice and Research

摘　　要：目的：探讨不同角度的头低臀高截石位对妇科宫腹腔镜联合手术患者的影响。方法：将2014年8月-2015年4月在我院行妇科宫腹腔镜联合手术的90例患者随机等分为3组,试验1组头低截石位的角度为10°-20°;试验2组头低截石位的角度为20°-30°;对照组头低截石位的角度为30°-40°。分别监测3组患者不同时间点血压、心率的变化,患者体位相关并发症发生情况及手术视野暴露满意度。结果：气腹后进行体位安置,3组患者血压均升高,体位恢复前血压逐渐恢复正常,3组比较均无统计学意义（P〉0.05）,但体位恢复后试验组与对照组比较均有统计学意义（P〈0.05）,试验1组和2组间比较无统计学意义（P〉0.05）。3组患者心率、不同时间点比较均无明显差异（P〈0.05）。试验1组和2组并发症发生均少于对照组（P〈0.05）。手术视野暴露满意度比较试验组均优于对照组（P〈0.05）且试验2组优于试验1组（P〈0.05）。结论：在妇科宫腹腔镜手术头低截石位体位配合中,采用20°-30°,能满足手术需要,降低体位改变对于血动力学的影响,减少对机体带来的不良影响,降低手术并发症。Objective： To explore the influence on gynecological laparoscopy surgery patient by head- low and buttocks- high lithotomy position with different angles. Methods： Divided 90 cases patients of gynecological laparoscopy combined surgery in our hospital from August,2014 to April,2015 into three groups. The angle of low head lithotomy position in experiment No. one group was 10° ~ 20°; the angle of low head lithotomy position in experiment No.two group was 20° ~ 30°; the angel of low head lithotomy position in control group was 30° ~ 40°. The changes of blood pressure,heart rate in different time,the occurrence situation of the related complications of patient position,operative field exposure satisfaction in three groups patients were monitored respectively. Results： Position placement was done after Pneumoperitoneum. The blood pressure of three group patients increased. The blood pressure returned to the normal before position returned. The comparison of three groups was not of statistic significance（ P〉0. 05）. However,the comparison between experiment group and control group was of statistic significance after position returned（ P〉0. 05）. The comparison between experiment No. one group and experiment No. two group was not of statistic significance（ P〉0. 05）. There was no difference in the comparison of heart rate and different time in three groups patients（ P〉0. 05）. The complication occurrence in experiment No. one and No. two group were less than control group（ P〉0. 05）. As for the operative field exposure satisfaction,experiment group was better than control group（ P〉0. 05） and experiment No. two group was better than experiment No. one group（ P〉0. 05）. Conclusion： In the coordination of gynecological laparoscopy surgery low head lithotomy position,the use of 20°-30° could satisfy the operation need,reduce the influence on hemodynamics by position changes,reduce the bad influence brought by organism and reduce the operation complication.

关 键 词：头低截石位 腹腔镜 臀高位 

分 类 号：R473.71[医药卫生—护理学]