改良海绵垫搁腿架摆放对全麻尿道吻合术中患者血流动力学及满意度的影响  

Effect of improved sponge cushion leg rest placement on hemodynamics and satisfaction of patients during general anesthesia urethral anastomosis surgery

作　　者：王玉保 王音[1] 郑亚 WANG Yubao;WANG Yin;ZHENG Ya(Operation Room,Shanghai Sixth People’s Hospital,Shanghai 201306,China;Department of Cardiovascular Medicine,Shanghai Sixth People’s Hospital,Shanghai 201306,China)

机构地区：[1]上海市第六人民医院手术室,上海201306 [2]上海市第六人民医院心血管内科,上海201306

出　　处：《中国医药导报》2024年第3期93-97,共5页China Medical Herald

基　　金：上海市自然科学基金面上项目(18ZR1438400)。

摘　　要：目的 探讨全麻尿道吻合术中采用不同搁腿架摆放对患者血流动力学及满意度的影响。方法 选取2021年1月至2022年1月上海市第六人民医院收治的行尿道吻合术治疗的患者200例,采用随机数字表法分为对照组和观察组,各100例。对照组采取传统硬质腿架托腿,观察组采用改良海绵垫搁腿架托腿。比较两组麻醉诱导前(T_(0))、麻醉诱导后即刻(T_(1))、手术30 min(T_(2))、术毕15 min(T_(3))平均动脉压(MAP)、心率(HR)、心排血量(CO)、每搏输出量(SV);比较两组术后2、4周残余尿量、最大尿流率;比较两组舒适度评分、满意度评分。结果 整体分析发现:两组MAP、HR、CO、SV组间、交互作用比较,差异无统计学意义(P>0.05),两组MAP、HR、CO、SV时间效应比较,差异有统计学意义(P<0.05)。组内比较:与T_(0)时比较,对照组T_(1)-T_(2)时MAP、HR、CO、SV降低,T_(3)时CO、SV降低(P<0.05);与T_(1)时比较,对照组T_(2)时HR降低,T_(3)时MAP、HR、CO、SV升高(P<0.05);与T_(2)时比较,对照组T_(3)时MAP、HR、CO、SV升高(P<0.05)。与T_(0)时比较,观察组T_(1)-T_(2)时MAP、HR、CO、SV降低,T_(3)时CO、SV降低(P<0.05);与T_(1)时比较,观察组T_(3)时MAP、HR、CO、SV升高(P<0.05);与T_(2)时比较,观察组T_(3)时MAP、HR、CO、SV升高(P<0.05)。组间比较:两组T_(0)~^(T)_(3)时MAP、HR、CO、SV比较,差异无统计学意义(P>0.05)。与术后2周比较,两组术后4周残余尿量降低、最大尿流率升高(P<0.05);术后2、4周,两组残余尿量、最大尿流率比较,差异无统计学意义(P>0.05)。观察组心理、生理评分高于对照组(P<0.05);两组社会文化、环境评分比较,差异无统计学意义(P>0.05)。观察组满意度优于对照组(P<0.05)。结论 全麻尿道吻合术中采用改良海绵垫搁腿架较传统硬质腿架托腿能有效提高患者舒适度及治疗满意度。Objective To investigate the effect of different leg rest placement on hemodynamics and satisfaction of patients during general anesthesia urethral anastomosis surgery.Methods A total of 200 patients receiving urethral anastomosis surgery in Shanghai Sixth People's Hospital from January 2021 to January 2022 were selected.They were divided into control group and observation group by random number table method,with 100 cases with each group.The control group received traditional rigid leg rest,and observation group received modified sponge cushion legrest.The mean arterial pressure(MAP),heart rate(HR),cardiac output(CO),and stroke volume(SV) between two groups were compared before anesthesia induction(T_0),immediately after anesthesia induction(T_1),30 min after surgery(T_2);and 15 min after surgery(T_3);the residual urine volume and maximum urine flow rate at two and four weeks after surgery were compared between two groups;and the comfort scores and satisfaction scores between two groups were compared.Results The overall analysis showed that there were no significant differences in the inter-group and interaction of MAP,HR,CO,and SV between two groups(P>0.05);while there was significant difference in the time effect of MAP,HR,CO,and SV between two groups(P<0.05).Intra-group comparison:compared with T_0,MAP,HR,CO,and SV of control group were decreased at T_1-T_2,and CO and SV were decreased at T_3(P<0.05);compared with T,,HR of control group was decreased at T_2,and MAP,HR,GO,and SV were increased at T_3(P<0.05);compared with T_2,MAP,HR,GO,and SV of control group were increased at T_3(P<0.05).Compared with T_0,MAP,HR,GO,and SV of observation group were decreased at T_1-T_2,and GO and SV were decreased at T_3(P<0.05);compared with T_1,MAP,HR,CO,and SV of observation group were increased at T_3(P<0.05);compared with T_2,MAP,HR,CO,and SV of observation group were increased at T_3(P<0.05).Comparison between groups:there were no significant differences in MAP,HR,GO,and SV between two groups at T_1-T_3(P>0.05).Compared

关 键 词：改良海绵垫搁腿架 全麻 尿道吻合术 体位 血流动力学 舒适度 满意度 

分 类 号：R699.6[医药卫生—泌尿科学]