眼科手术可调节塑型L形给氧支架的研制与应用  

Development and application of adjustable L-shaped oxygen supply holder for ophthalmic surgery

作　　者：陈彩芬[1] 黄美娜[1] 凌晓浅[1] 彭园园[1] 陈聪[1] 章菁菁[1] 金约西[2] 陈燕燕[3] 

机构地区：[1]温州医科大学附属眼视光医院手术中心,温州市325000 [2]温州医科大学附属眼视光医院麻醉科,温州市325000 [3]温州医科大学附属眼视光医院护理部,温州市325000

出　　处：《中华护理杂志》2017年第2期249-253,共5页Chinese Journal of Nursing

基　　金：2014年度温州市科学技术局课题(Y20140179);浙江省医药卫生重大科技计划重点项目(WKJ-ZJ-1727)

摘　　要：目的解决眼科局部麻醉手术患者头面部手术巾覆盖导致的通气不畅及缺氧的问题,提高手术安全性。方法研制一种安装于手术床栏的L形给氧支架,由固定器、竖向管及横向支架构成。横向支架由中空的不锈钢管连接不锈钢可塑型软管,远端连接盲端有开孔的聚氯乙烯圆筒。支架内置氧气导管,鼻塞头对准盲端开孔。使用时将支架的软管转向患者胸部上方,向下斜行向头侧,圆筒置于下唇与下颏之间上方,铺设无菌巾后,横向支架的不锈钢部分与软管部分形成了L形支撑。选择23 G玻璃体切除术患者随机分组,观察组73例应用L形给氧支架,对照组74例使用传统鼻导管吸氧,氧气输入浓度均为2 L/min。结果两组的心率变化无明显差异,SpO_2均在正常值范围内,但观察组SpO_2维持明显优于对照组,差异有统计学意义(P<0.05)。通气舒适度自评分及自诉不舒适感显示,观察组舒适度明显优于对照组,差异有统计学意义(P<0.05)。结论 L形可塑型给氧支架将支起口鼻部的铺巾及提高铺巾下空气氧含量的功能合二为一,改善眼科手术中自主呼吸患者铺巾下的迷你呼吸环境,有效提高术中患者的血氧饱和度和通气舒适度。支架操作简便,缩短术前准备时间,提高眼科连台手术效率。Objective To solve the low ventilation and hypoxia for patients undergoing ophthalmic local anesthe- sia surgery covered by operating drape. Methods A L-shape oxygen supply holder was developed,which was composed with a fixator,a vertical tube,a transverse tube and a holder. The transverse tube was a hollow stainless tube which was connected to a plastic stainless soft tube at one end,as the other end connected to a lacunal PVC cylinder. The oxygen supply holder had a build-in oxygen cannula,wbieh was aligned to the PVC aperture. The soft tube was aligned along the patient＇s chest,tihed to the head and put the cylinder between underlip and chin projection. The stainless part of transverse tube and soft tube would form a L-shape holder. Then 23-guage vitrectomy patients were recruited and assigned into two groups：73 patients used L-shape oxygen supply holder （the experimental group）,74 patients used traditional nasaleannule （the control group）. Oxygen concentration was 2 L/min in both groups. Results Change in heart rate was not significantly different between two groups. The SpOz of both groups were in normal range. However,the maintenance of SpO2 in the experiment group was significantly better than that in the control group （P〈0.05）. Conclusion The L-shape oxygen supply holder combined the function of holding up the drape and increasing the oxygen content of the air,which could improve the mini-breathing circumstance,oxyhemoglobin saturation,and comfort of patients during ophthalmic surgery. The holder was easy to operate, and could reduce the preparing time ,and improve the efficacy of continuous surgery.

关 键 词：眼外科手术 支架 给氧 

分 类 号：R472[医药卫生—护理学]