乳腺癌手术中使用改良L型肢体支架的安全性、舒适性及压力性损伤预防效果评价  

Evaluation of safety, comfort and prevention of pressure injury using the modified L-shaped limb stent in breast cancer surgery

作　　者：祁珊珊 戴荣兄[2] QI Shanshan;DAI Rongxiong(Department of Anesthesiology and Surgery,Jiangsu Province Hospital,Jiangsu,Nanjing 210029,China)

机构地区：[1]江苏省人民医院麻醉手术科,南京市210029 [2]江苏省人民医院麻醉与围术期医学科

出　　处：《河北医药》2024年第24期3763-3766,共4页Hebei Medical Journal

基　　金：国家自然科学基金资助项目(编号:82000305)。

摘　　要：目的研究改良L型肢体支架在乳腺癌手术中应用的安全性、舒适度及预防压力性损伤(PI)的临床效果。方法选取2022年1月至2023年6月以手术室接受传统术式下乳腺癌根治术治疗的乳腺癌患者90例为本次研究对象,90例患者以数字表随机法分为试验组与对照组,每组45例。对照组常规望月式体位管理及手术室干预,试验组应用改良L型支架实施体位管理,对比不同干预方案对乳腺癌手术期间患者安全性、舒适度、PI发生率的影响差异。结果试验组乳腺癌患者的手术时间、体位摆置时间更短,术中体位调整频次相比对照组均更低(P<0.05);试验组乳腺癌患者的术中体位相关并发症发生率相比对照组均更低(P<0.05);试验组乳腺癌患者上肢麻木与疼痛评分、手指与上肢活动度下降率相比对照组明显更低(P<0.05);试验组乳腺癌手术主刀医生与麻醉师对体位摆置的满意度评分相比对照组明显更增高(P<0.05)。结论改良L型肢体支架联合“望月式”体位的安全性良好,可降低术中并发症发生风险,缩短手术及体位摆置时间,降低体位调整次数,且患者舒适度更高,医生满意度更高。Objective To study the safety,comfort and prevention of pressure injury(PI)using the modified L-shaped limb stent in breast cancer surgery.Methods Ninety patients with breast cancer who received radical mastectomy under traditional surgery in the operating room from January 2022 to June 2023were selected as the subjects.They were randomly assigned to the experimental group(45 cases)and the control group(45 cases)by numerical table randomization.Patients in the control group received routine moon gazing position(supine position)and surgical intervention,and those in the experimental group received modified L-type stent for position management.Safety,comfort and PI incidence during breast cancer surgery were compared.Results The operation time and position positioning time of experimental group were significantly shorter,and the frequency of position adjustment was significantly lower than that of control group(P<0.05).The incidence of postural complications in the experimental group was significantly lower than that of control group(P<0.05).The scores of upper limb numbness and pain,and the decline rate of finger and upper limb motion in the experimental group were significantly lower than those of control group(P<0.05).Compared with those of the control group,the satisfaction scores of breast cancer surgery graded by doctors and anesthesiologists were significantly higher in the experimental group(P<0.05).Conclusion The modified L-shaped limb stent combined with the moon gazing position has a good safety,which can reduce the risk of intraoperative complications,shorten the operation and position positioning time,reduce the number of position adjustments,and improve the comfort and doctor satisfaction.

关 键 词：乳腺癌根治术 “望月式”体位 改良L型支架 安全性 舒适度 压力性损伤 手术室护理 

分 类 号：R737.9[医药卫生—肿瘤]