基于舒适护理理论改进后的头低足高截石位摆放技术在腔镜手术中的应用效果  

Application effect of improved head-low-foot-high lithotomy placement technique in lumpectomy based on comfort care theory

作　　者：沈俏微 徐学军 黄象琼 郑晓玲 向彩云 SHEN Qiaowei;XU Xuejun;HUANG Xiangqiong;ZHENG Xiaoling;XIANG Caiyun(Operating Room,Ningbo Women’s and Children’s Hospital,Zhejiang Province,Ningbo 315010,China)

机构地区：[1]浙江省宁波妇女儿童医院手术室,浙江宁波315010

出　　处：《中国医药导报》2023年第7期173-176,189,共5页China Medical Herald

基　　金：浙江省医药卫生科技计划项目(2019PY076)。

摘　　要：目的分析基于舒适护理理论改进后的头低足高截石位摆放技术在妇科恶性肿瘤腔镜手术中的应用效果。方法将浙江省宁波妇女儿童医院于2019年10月至2020年2月收诊的100例妇科恶性肿瘤患者采用随机数字表法分为两组,各50例。对照组术中采用常规头低臀高截石位,观察组采用基于舒适护理理论改进的头低足高截石位摆放技术。观察患者动脉压[检测时间点为T_(1)~T_(3),即麻醉完成后平卧截石位(T_(1))、气腹并头低臀高位后5 min(T_(2))、气腹并头低臀高后30 min(T_(3))]的波动、体位相关并发症、体位舒适度情况。结果两组平均动脉压水平比较,差异统计学意义(P<0.05)。其中观察组T_(2)、T_(3)时间点平均动脉压低于对照组,差异有统计学意义(P<0.05)。术后24 h,观察组肩部、下肢麻木疼痛视觉模拟评分法(VAS)评分低于对照组,差异有统计学意义(P<0.05)。术后48 h,两组肩部、下肢麻木疼痛VAS评分低于术后24 h,差异有统计学意义(P<0.05)。术后48 h,两组肩部、下肢麻木疼痛VAS评分比较,差异无统计学意义(P>0.05)。观察组皮下气肿比例低于对照组,体位舒适度评分高于对照组,差异有统计学意义(P<0.05)。结论基于舒适护理理论改进的头低足高截石位摆放技术用于妇科恶性肿瘤腹腔镜手术中,发挥良好动脉压波动缓解、体位相关预防、疼痛缓解作用,可有效提升患者体位舒适度。Objective To analyze the effect of improved head-low-foot-high lithotomy placement technique based on comfort care theory in lumpectomy for gynecologic malignancies.Methods One hundred patients with gynecological malignancies admitted to Ningbo Women’s and Children’s Hospital,Zhejiang Province from October 2019 to February 2020 were divided into two groups of 50 cases each using the random number table method.In the control group,the conventional head-low-hip-high lithotomy position was used intraoperatively,while the observation group used a modified head-low-foot-high lithotomy position technique based on comfort care theory.The fluctuations of arterial pressure lthe time points of detection were T_(1) to T_(3),i.e.after completion of anesthesia in the flat-lying truncal position[T_(1)],5 min after pneumoperitoneum with head low,and hip high position[T_(2)],and 30 min after pneumoperitoneum with head low and hip high position[T_(3)],position-related complications,and position comfort were observed.Results The difference in mean arterial pressure levels between the two groups was statistically significant(P<0.05).The mean arterial pressure at T_(2) and T_(3) time points in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).At 24 h after surgery,the visual analogue scale(VAS)scores of numbness and pain in the shoulder,and lower limbs of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).At 48 h postoperatively,the VAS scores of numbness and pain in the shoulder,and lower limbs were lower in both groups than at 24 h postoperatively,and the differences were statistically significant(P<0.05).At 48 h postoperatively,there were no statistically significant differences in the VAS scores of numbness and pain in the shoulder and lower limbs between the two groups(P>0.05).The proportion of subcutaneous emphysema in the observation group was lower than that in the control group,w

关 键 词：妇科恶性肿瘤 腔镜手术 舒适护理理论 头低足高截石位 

分 类 号：R473.72[医药卫生—护理学]