跪俯卧位联合个案管理模式在腹腔镜肾上腺手术中的应用效果  

Efect of kneeling and prone position combined with case management mode in laparoscopic adrenal surgery

作　　者：阚峰玉 郁晓红 谢建军[1] 张琰[1] 陆彩萍 张锦 KAN Fengyu;YU Xiaohong;XIE Jianjun(Operating Room,Suzhou Science&Technology Town Hospital Affiliated to Nanjing Medical University,Jiangsu,Suzhou 215183,China)

机构地区：[1]南京医科大学附属苏州科技城医院手术室,江苏省苏州市215183

出　　处：《河北医药》2023年第2期224-227,共4页Hebei Medical Journal

基　　金：苏州科技城医院院级预研护理部基金Ⅰ类项目(编号:21HLA001);苏州市医学重点扶持学科(编号:SZFCXK202109)。

摘　　要：目的 探究跪俯卧位联合个案管理模式在腹腔镜肾上腺手术中的应用效果。方法 将2017年5月至2020年12月收治的80例将行腹腔镜肾上腺手术患者选为研究对象,采取随机数表法,平均分为对照组和观察组,每组40例。对照组行侧卧位联合常规管理模式,观察组行跪俯卧位联合个案管理模式。比较2组围术期相关指标及并发症情况、医生手术操作中的疲劳程度、医生对手术体位满意度、降压效果及护理满意度。结果 观察组术后恶心、呕吐、气体栓塞的发生率,以及住院时间、术后首次排气时间、首次下床活动时间和术中出血量均小于对照组(P<0.05);医生在2组手术操作1 h内眨眼频率比较差异无统计学意义(P>0.05),但>1 h后眨眼频率明显低于对照组,且其上臂与躯干夹角、脊柱侧弯角度小于对照组(P<0.05);医生对观察组手术体位满意率高于对照组(P<0.05);术后,观察组患者收缩压、舒张压低于对照组,心率高于对照组(P<0.05);观察组患者对护理质量的满意率高于对照组(P<0.05)。结论 针对腹腔镜肾上腺手术患者,采取跪俯卧位联合个案管理模式可提高患者安全性和疗效,减少医生在手术中的疲劳程度,提高医生和患者的满意度。Objective To explore the application effect of kneeling prone position combined with case management mode in laparoscopic adrenal surgery.Methods A total of 80 patients who underwent laparoscopic adrenal surgery admitted to our hospital from May 2017 to December 2020 were enrolled as the research objects.They were randomized 1∶1 to receive lateral recumbent position + the conventional management mode(the control group) or kneeling prone position + case management mode(the observation group).The perioperative indicators,complications,fatigue degree of doctors during the operation,satisfaction of doctors to the surgical position,antihypertensive effect and nursing satisfaction were included as comparison.Results The incidence of postoperative nausea,vomiting,and gas embolism,the length of hospital stay,the time to first exhaust after operation,the time to get out of bed for the first time,and the amount of intraoperative blood loss in the observation group were all significantly lower than those in the control group(P<0.05).There was no significant difference in the blinking frequency of the group within 1 hour of operation(P>0.05),but the blinking frequency after 1 hour was significantly lower than that of the control group,and the angle between the upper arm and the trunk and the angle of scoliosis were significantly smaller than those of the control group(P<0.05).The rate of satisfaction of doctors to the surgical position in the observation group was significantly higher than that in the control group(P<0.05).After operation,the systolic blood pressure and diastolic blood pressure in the observation group were significantly lower than those in the control group,and the heart rate was significantly higher than that in the control group(P<0.05).The satisfaction rate of quality was significantly higher than that of the control group(P<0.05).Conclusion For patients with laparoscopic adrenal surgery,the two combination can improve the safety and efficacy,reduce the fatigue of doctors during surgery,and improve the

关 键 词：跪俯卧位 个案管理模式 腹腔镜 肾上腺 应用效果 围术期护理 

分 类 号：R699.3[医药卫生—泌尿科学]