摘要
目的探讨分阶段体位安置法在老年腹腔镜直肠癌根治手术过程中的应用效果。方法选取我院2018年1月至2019年12月收治的97例行腹腔镜Miles术的老年病人为研究对象,其中2018年1~12月45例病人纳入对照组,2019年1~12月52例病人纳入试验组。对照组使用普通的截石位托腿架、手术全程采用改良截石位;试验组使用马镫形气动腿架,并将手术全程大致分为三个阶段,不同阶段采取相应的手术体位。比较2组病人术后下肢肿胀及深静脉血栓的发生率、下肢的舒适度以及术者对手术体位的满意度。结果试验组术后24 h病人下肢肿胀的发生率低于对照组,下肢的舒适度及术者对手术体位的满意度均优于对照组,差异有统计学意义(P<0.05或P<0.01);术后72 h内2组均无下肢深静脉血栓形成。结论对老年病人采用分阶段体位安置方法,既能降低截石位并发症的发生率,增加病人术后的舒适度,又能充分地暴露手术部位,方便术者操作。
Objective To explore the effect of staged placement in laparoscopic radical operation of rectal cancer in the elderly.Methods A total of 97 elderly patients undergoing laparoscopic Miles operation from January 2018 to December 2019 in our hospital were enrolled in this study,among which 45 patients from January to December 2018 were divided into the control group and 52 patients from January to December 2019 were divided into the study group.In the control group,the modified leg supporting frame was used throughout the operation.In the study group,the stirrup pneumatic leg supporting frame was used,and the whole operation was roughly divided into three stages,and the corresponding operation position was adopted at different stages.The incidence of postoperative lower extremity swelling and deep vein thrombosis,the comfort of lower extremity and the satisfaction for the operation position of the operator were compared between the two groups.Results The incidence of lower extremity swelling in the study group was lower than that in the control group 24 h after operation,and the comfort degree of lower extremity and the satisfaction degree of the operator for the operation position were better than those in the control group,with significant difference(P<0.05);There was no deep vein thrombosis in the two groups 72 hours after operation.Conclusions The placement of the elderly patients in different stages can not only reduce the incidence of complications and increase the postoperative comfort,but also fully expose the operation site and facilitate the operation.
作者
王凯
张青
张春艳
刘业六
王正梅
WANG Kai;ZHANG Qing;ZHANG Chun-yan;LIU Ye-liu;WANG Zheng-mei(Department of Surgery and Anesthesiology,the Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University,Huaian 223300,China;Depanment of Nursing,the Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University,Huaian 223300,China;Department of Gastrointestinal Surgery,the Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University,Huaian 223300,China)
出处
《实用老年医学》
CAS
2021年第6期638-641,共4页
Practical Geriatrics
