枕下乙状窦后入路听神经瘤切除术中传统侧俯卧位与改良仰卧位对手术进程的影响  

Evaluation the Surgical Process Between Traditional Contralateral Prone Position and Modified Supine Position Under Suboccipital Retrosigmoid Approaching for Acoustic Neuromas Resection

作　　者：李莉 马明珠 陈茂君 Li Li;Ma Mingzhu;Chen Maojun(West China School of Nursing,Sichuan University/Department of Neurosurgery&Outpatient Department of Neurology,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,China)

机构地区：[1]四川大学护理学院/四川大学华西医院神经外科,神经内科门诊部,四川成都610041

出　　处：《四川医学》2021年第6期598-601,共4页Sichuan Medical Journal

摘　　要：目的评估传统侧俯卧位摆体位与改良仰卧位摆体位在枕下乙状窦后入路听神经瘤切除术中对手术进程的影响。方法回顾性分析我院2019年11月至2020年5月两种体位下通过显微外科手术治疗的72例听神经瘤患者临床资料及术中护理资料,A组予以Mayfield头架辅助传统侧俯卧摆体位34例,B组予以Mayfield头架辅助改良仰卧摆体位38例,并就两组摆体位方法对患者手术进程的影响(摆体位时间,术中是否切除小脑外1/3组织)进行比较。结果A组摆体位时间(16.5±5.5)min,术中切除小脑组织2例,切小脑率为5.88%;B组摆体位时间(7.1±2.3)min,术中切除小脑组织9例,切小脑率为23.68%,两组摆体位时间及切小脑率比较,差异均有统计学意义(t=9.64,P<0.01;χ^(2)=4.39,P<0.05)。结论枕下乙状窦后入路听神经瘤切除术中,相比于传统侧俯卧位,改良仰卧位摆体位虽能明显缩短摆体位时间,但也能增加术中切除小脑的概率;术前巡回护士、外科医师及麻醉医师需根据患者具体情况采取一种最佳的体位摆放方式。Objective To evaluate the surgical process between traditional contralateral prone position and modified supine position under suboccipital retrosigmoid approaching for acoustic neuromas resection.Methods Retrospectively analyzed the clinical and nursing data of 72 patients with acoustic neuromas,who received microsurgical treatments under two ways of position in our hospital from 2019 November to 2020 May.In group A,34 patients were given traditional contralateral prone position with the assistance of Mayfield head holder;in group B,38 patients were given modified supine position under the assistance of Mayfield head holder.The surgical process(positioning time,whether resection lateral cerebellum 1/3 or not intraoperatively)between the two groups were compared.Results In group A,positioning time was(16.5±5.5)minutes,cerebellum resection was achieved in 2 cases and the resection rate was 5.88%;in group B,positioning time was(7.1±2.3)minutes,cerebellum resection was achieved in 9 cases and the resection rate was 23.68%,The difference was statistically significant between the two groups(t=9.64,P<0.01;χ^(2)=4.39, P <0.05). Conclusion During the surgical management of acoustic neuromas by suboccipital retrosigmoid approaching,compared with the traditional contralateral prone position,modified supine position can significantly shorten the time of positioning,but also increases the probability of resection lateral cerebellum.Circulating nurses,surgeons and anesthesiologists need to adopt an appropriate position according to the patients’ own situation.

关 键 词：枕下乙状窦后入路 摆体位时间 小脑组织 

分 类 号：R473.73[医药卫生—护理学]