半俯卧位在胸腹腔镜食管癌根治术中的应用  

Application of semipronation in thoracic laparoscopy for esophageal cancer

作　　者：唐红华[1] 卢秀英[1] 江小芳[1] 金海龙[1] 柳露[1] 

机构地区：[1]四川省肿瘤医院手术室,四川成都610041

出　　处：《中国医药导报》2017年第23期92-95,共4页China Medical Herald

摘　　要：目的探讨半俯卧位在胸腹腔镜食管癌根治术中的应用。方法选择2013年4月~2014年10月四川省肿瘤医院经上腹、右胸、左颈行胸腹腔镜下食管癌根治术106例食管癌患者,采用随机数字表法分为对照组和实验组,每组各53例。两组在胸腔镜下游离胸段食管和纵隔淋巴结清扫时分别采用半俯卧位和正侧卧位两种方法。监测安置体位前后有创血压、心率、气道压,评价术野暴露情况,记录手术时间以及患者术后舒适度。结果体位安置后实验组血压下降,对照组血压升高(P<0.05);两组气道压均升高(P<0.05);两组心率均无无明显变化(P>0.05)。实验组体位手术时间明显低于对照组(P<0.05);实验组舒适度评分明显高于对照组(P<0.05);实验组术野质量高于对照组(P<0.05)。结论半俯卧位在胸腹腔镜食管癌根治术中既能满足充分暴露手术野和维持患者的舒适度,又能保持患者术中良好的循环功能,在缩短手术时间的同时也保证了患者的安全。Objective To explore the application of semipronation in thoracic laparoscopy for esophageal cancer. Meth- ods From Apirl 2013 to October 2014, in Sichuan Cancer Hospital, 106 esophageal cancer patients with two methods of the radical operation of esophageal cancer were selected, and they were divided into test group and control group by random number table, patients in two groups were given semiprone position and positive side position when separating the tumor and cleaning up mediastinal lymph nodes respectively. The BP, HR and AP before and after the body posi- tion were monitored. The surgical field exposure, operation time and the degree of comfort effect of body position inter- vention were discussed. Results After the operation position changed, the blood pressures were lower than before in the test group, but those were higher in the control group （P 〈 0.05）. The air pressures after position change were higher than those before in two groupd （P 〈 0.05）, and the heart rate had no obvious change in the two groups （P 〉 0.05）. The opera- tion time of the test group was significantly shorter than that of the control group （P 〈 0.05）. The comfort score of the test group was significantly higher than that of the control group （P 〈 0.05）. The operation field quality of the test group was higher than that of the control group （P 〈 0.05）. Conclusion The semipronation can not only fully expose the surgi- cal field,but also maintain satisfactory hemodynamics.In conclusion,the semipronation can shorten the operation time as well as ensure the safety of patients.

关 键 词：食管癌 胸腔镜 腹腔镜 半俯卧位 

分 类 号：R472.3[医药卫生—护理学]