三种手术体位在鼻内窥镜下鼻窦手术中应用的对比研究  

A comparative study of three surgical positions in sinus surgery under nasal endoscope

作　　者：邓君 王双珠 张娣 DENG Jun;WANG Shuangzhu;ZHANG Di(Department of Surgical Anesthesiology,Longhua Central Hospital,Shenzhen 518000,China)

机构地区：[1]广东省深圳市龙华区中心医院手术麻醉科,广东深圳518000

出　　处：《广州医科大学学报》2023年第5期16-19,共4页Academic Journal of Guangzhou Medical University

基　　金：龙华区医疗卫生机构区级科研项目(2021160)。

摘　　要：目的:探究三种手术体位在鼻内窥镜下鼻窦手术中应用。方法:选取2021年1月至2022年12月我院收治的行鼻内窥镜下鼻窦手术患者150例为研究对象,采用随机数表法分为仰卧位、半坐卧位和斜仰卧沙滩椅位三组,各50例。统计患者手术出血量,观察并统计患者手术结束即刻、术后12 h、术后24 h皮肤压红、皮肤弹性变化、皮肤压疮情况,比较手术医生的舒适度、满意度及麻醉医生、巡回护士、手术医生对三种手术体位的应用效果评价。结果:三组患者手术出血量为仰卧位>半坐卧位>斜仰卧沙滩椅位(P<0.05);患者手术结束即刻、术后12 h皮肤压红、皮肤弹性变化、皮肤压疮情况为仰卧位>半坐卧位>斜仰卧沙滩椅(P<0.05),术后24 h仰卧位及半坐卧位均有出现皮肤压疮情况,而斜卧沙滩椅位未见皮肤压疮;手术医生舒适度、满意度及应用效果评价为斜仰卧沙滩椅位>半坐卧位>仰卧位(P<0.05)。结论:三种手术体位中,斜仰卧沙滩椅位体位患者术中出血量少,患者皮肤压红、皮肤弹性变化、皮肤压疮情况少,医生舒适度及满意度更高,应用效果评价更好,具有更好的应用优势。Objective:To explore the application of three surgical positions in sinus surgery under nasal endoscope.Methods:A total of 150 patients undergoing endoscopic sinus surgery in our hospital from January 2021 to December 2022 were selected as the study objects,and were divided into supine position,semi⁃seated position and inclined supine beach chair groups by random number table method,with 50 cases in each group.The amount of surgical bleeding of patients was counted,and the situation of skin pressure redness,skin elasticity change and skin pressure sore immediately after surgery,12 h and 24 h after surgery were observed and counted.The comfort and satisfaction of surgeons were compared,and the application effects of anesthesiologists,traveling nurses and surgeons on the three surgical positions were evaluated.Results:The operative blood loss in the three groups were supine>semi⁃seated>oblique supine beach chair(P<0.05).Immediately after the operation,12 h after the operation,the skin pressure red,skin elasticity changes,skin pressure sores in supine position>semi⁃seated position>oblique supine beach chair(P<0.05).24 hours after the operation,there were skin pressure sores in supine position and semi⁃seated beach chair,but no skin pressure sores in oblique beach chair.The evaluation of comfort,satisfaction and application effect of surgeons was inclined supine beach chair>semi⁃seated supine>supine position(P<0.05).Conclusions:Among the three surgical positions,the inclined supine beach chair position has less intraoperative blood loss,less skin pressure redness,skin elasticity changes and skin pressure sores,higher comfort and satisfaction of doctors,better evaluation of application effect,and better application advantages.

关 键 词：手术体位 鼻窦手术 鼻内窥镜 半坐卧位 斜仰卧沙滩椅位 

分 类 号：R762[医药卫生—耳鼻咽喉科]