摘要
目的通过对在陆地和不同摇摆度模拟器内开展脾切除术和胸腔闭式引流术进行对比研究,初步了解不同海况下卫生船舶内完成胸腹部手术情况及完成手术用时变化,为评估卫生船舶战时救治能力提供参考。方法通过Delphi法,咨询全军野战外科专业15名专家,通过3轮咨询,筛选出脾切除术和胸腔闭式引流术做为胸腹部急救手术的代表术式。20只成年杂种犬随机分成A组(陆基组)、B组(2级海况组)、C组(5级海况组)、D组(8级海况组),每组5只,行脾切除术和胸腔闭式引流术,记录手术完成情况及所用时间(s),同时记录实验过程中手术人员反应和影响手术完成的因素。结果 4组手术均顺利完成,B、C组完成脾切除术用时与A组无统计学差异(P>0.05),D组完成脾切除术用时与B、C组有统计学差异(P<0.05),与A组比较有非常显著差异(P<0.01)。而各组行胸腔闭式引流术所用时间均无统计学差异(P>0.05)。实验过程中,手术人员轻度头晕,但对完成手术操作无明显影响。结论卫生船舶在8级以下海况条件,手术人员可顺利完成胸腹部急救手术,当摇摆幅度较大时,完成复杂手术难度及手术用时相应增加,而对简单操作影响不大。
Objective To study the impact of ship vacillation under different sea conditions on the thoracic and abdominal operations,and to help evaluate the rescuing ability of medical ship during war.Methods We selected splenectomy and closed thoracic drainage as representative operations by the Delphi method.Totally 20 mongrel dogs were randomly divided into group A（the continental group,n=5）,group B（the second level sea conditions group,n=5）,group C（the fifth level sea conditions group,n=5） and group D（the eiqhth-level sea conditions group,n=5）.The operation time,reactions of surgeons and nurses,and factors affecting the operation were recorded.Results The operations were accomplished smoothly in every group,and there was no significant difference among 4 groups having closed thoracic drainage（P0.05）.But when having splenectomy,significant differences were showed between group D and group A（P0.01）,group B and group C（P 0.05）.However,there was no significant difference among group A,B and C（P0.05）.Conclusion Simple operation can be accomplished smoothly in medical ship under the eighth-level sea conditions,otherwise it will be more difficult to accomplish complicated operation with the increasing of swing angle.
出处
《创伤外科杂志》
2012年第3期262-264,共3页
Journal of Traumatic Surgery
关键词
胸腹损伤
脾切除术
胸腔闭式引流
海上救援
实验
thoracoabdominal
splenectomy
closed thoracic drainage
rescue at sea
experiment
