新型患肢固定牵引带在肩关节镜手术侧卧牵引位中的应用  

Application of a new type of fixed traction belt for the affected limb in lateral traction position during shoulder arthroscopic surgery

作　　者：刘佳琳[1] 王晓宁[1] 黄晓虹[1] 刘佳[1] 李亘 严彬[1] Jialin Liu;Xiaoning Wang;Xiaohong Huang;Jia Liu;Gen Li;Bin Yan(Operating Room of Shanghai Jiao Tong University School of Medicine Affiliated Ruijin Hospital,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院手术室,200025

出　　处：《中华肩肘外科电子杂志》2023年第2期122-127,共6页Chinese Journal of Shoulder and Elbow(Electronic Edition)

摘　　要：目的探讨新型患肢固定牵引带在肩关节镜手术侧卧牵引位中的应用效果。方法选择2021年1月至12月于上海交通大学医学院附属瑞金医院骨科病区行肩关节镜手术的317例患者作为研究对象,按照随机数字表法分为观察组和对照组。观察组患者肩关节镜手术中使用新型患肢固定牵引带固定牵引患肢,对照组患者肩关节镜手术中使用皮肤牵引带固定牵引患肢,对两组患者术前体位准备的时间、体位摆放术者的满意度、术后体位恢复的时间、牵引相关术后并发症的发生情况进行比较。结果两组患者术后均完成至少3个月随访。观察组患者术前体位准备的时间为(4.55±1.05)min,少于对照组(6.65±1.15)min,组间比较差异有统计学意义(P<0.05);观察组体位摆放术者的满意度为(47.00±1.34)分,优于对照组(41.58±2.18)分,组间比较差异有统计学意义(P<0.05);观察组术后体位恢复的时间为(2.96±0.83)min,少于对照组(4.54±1.11)min,组间比较差异有统计学意义(P<0.05);观察组患者术后牵引相关并发症为0例,对照组术后牵引相关并发症为3例;两组患者术前美国肩肘外科协会评分差异无统计学意义(P>0.05),术后2周、6周、3个月随访美国肩肘外科协会评分均较术前有明显提高,组间比较差异无统计学意义(P>0.05)。结论新型肩关节镜患肢固定牵引带在侧卧牵引手术体位中的应用有利于肩关节镜手术的开展,缩短了手术术前体位安放的时间和术后体位恢复的时间,提高了体位摆放术者的满意度,降低了牵引相关的术后并发症的发生,具有临床推广价值。Background In recent years,with the continuous progress of shoulder arthroscopy technology,shoulder arthroscopy has become a primary surgical method for rotator cuff injury and is becoming increasingly mature.With its advantages of small invasion,quick postoperative recovery,and intuitive operation,shoulder arthroscopy can be used to observe,diagnose and deal with shoulder joint lesions,successfully avoiding the shortcomings of traditional surgery with considerable trauma and many complications and improving the treatment comfort of patients.Appropriate surgical position affects the comfort of patients and is the basis for the success of shoulder arthroscopic surgery.Due to the shoulder joint’s unique anatomical morphology,most surgical positions are beach chair or lateral traction position,which is slightly less exposed to glenohumeral joint space.Moreover,controlled intraoperative hypotension is likely to cause a sharp decrease in cerebral perfusion volume and increase the risk of anesthesia,so lateral traction position has been more widely used in our hospital.The lateral traction position requires the patient to lean back 20°-30°,suspend the distal end of the affected limb in traction,abduct about 45°,bend forward 10°-15°,and put the upper limb in suspension position(the upper limb fixed traction equipment and traction frame are required to use).The traction strap used clinically for the affected limb is a skin traction strap,which means wrapping the forearm with a cotton pad,reserving bandages of sufficient length,wrapping the remaining bandages in a circular way from the far end of the arm to the near end,then folding and wrapping them around the wrist to tie and fix them,and connecting the reserved bandages to the traction rack at the end of the bed.There are some problems in using this method,such as extended time for preoperative position preparation and postoperative position recovery,poor traction effect,increasing assistant burden,inconvenient observation of traction direction during surgery,an

关 键 词：运动医学 肩关节镜手术 固定牵引带 侧卧牵引位 

分 类 号：R473.6[医药卫生—护理学]