一种新型自制体位垫在改良斜仰截石位经皮肾镜碎石术中的应用  

The clinical application of a new self-made postures pad for patients with modified oblique lithotomy position in percutaneous nephrolithotomy

作　　者：李季鸥 吴燕 吴建挺 钮敏红[1] 龚喜雪[1] Li Jiou;Wu Yan;Wu Jianting;Niu Minhong;Gong Xixue(Shenzhen Second People's Hospital/First Affiliated Hospital of Shenzhen University,518035,China)

机构地区：[1]深圳市第二人民医院/深圳大学第一附属医院,518035

出　　处：《国际护理学杂志》2023年第15期2774-2778,共5页international journal of nursing

基　　金：深圳市第二人民医院护理新技术立项2019060025(A1专科护理新技术);深圳市“医疗卫生三名工程”项目(SZSM202111007);深圳市医学重点学科建设经费(No.SZXK020)。

摘　　要：目的:探讨一种新型自制体位垫在改良斜仰截石位经皮肾镜碎石术(PCNL)术中的应用效果。方法:选取2019年9月至2020年11月在深圳市第二人民医院手术室择期接受PCNL患者120例,采用随机数字法分为实验组(行改良斜仰截石位)和对照组(行俯卧位),每组60例。实验组所有患者使用一种新型自制体位垫,将患者摆放成改良斜仰截石位;对照组将患者摆放成经典的俯卧位;两组分别接受PCNL。记录两组患者的术前一般资料、手术时间、手术操作时间、Ⅰ期结石清除率、手术大出血发生率、术中低血压发生率及术中周围脏器损伤发生率。结果:实验组所需手术时间(113.43±8.56)min明显短于对照组(137.18±8.58)min,术中低血压发生率3.33%(2/60)明显低于对照组18.33%(11/60),差异均有统计学意义(P<0.05);两组手术操作时间、Ⅰ期结石清除率、手术大出血发生率及术中周围脏器损伤发生率比较差异无统计学意义(P>0.05)。结论:在PCNL手术时采用新型体位垫,可以为其提供良好的手术操作空间,优化手术流程,提高工作效率,且术中低血压发生率较低。Objective To investigate the efficacy of a new homemade positional cushion in modified oblique tilt lithotomy position for percutaneous nephrolithotripsy(PCNL).Methods From September 2019 to November 2020,a total of 120 patients who underwent elective percutaneous nephrolithotomy under general anesthesia with modified oblique lithotomy position in this hospital were randomly divided into observation group(modified oblique lithotomy position)and control group(prone position),60 patients in each group.In observation group,all of the patients using a new type of home-made postures pad,and putted patients into modified oblique lithotomy position;Patients in the control group were placed in the classic prone position;percutaneous nephrolithotomy was performed respectively.Preoperative general information,operation time,operating time,stage I stone removal rate,incidence of surgical hemorrhage,incidence of intraoperative hypotension,and incidence of intraoperative peripheral organ injury were recorded for both groups.Results The whole operative time of the observation group(113.43±8.56)min was significantly shorter than that of the control group(137.18±8.58)min.The incidence of intraoperative hypotension(2/60)in observation group was significantly lower than that of the control group(11/60).Operation time,the incidence of calculi clearance by the initial percutaneous nephrolithotomy,the incidence of bleeding and i intraoperative peripheral viscera injury,there is no difference between two groups.Conclusions The use of a new postural pad in percutaneous nephrolithotomy with modified oblique lithotomy position can not only provide the same operating condition with the prone position,but also optimize the operating room nursing process,make whole of operation time shorter,and the incidence of intraoperative hypotension is lower,worthy of promotion in clinical practice.

关 键 词：体位垫 斜仰截石位 经皮肾镜碎石术 

分 类 号：R473.6[医药卫生—护理学]