| 徐惠锋,王昊珏.改良截石位妇科腹腔镜手术 48例观察[J].安徽医药,2019,23(10):2040-2043. |
| 改良截石位妇科腹腔镜手术 48例观察 |
| Observation on 48 cases of improved lithotomy position on patients undergoing gynecological laparoscopic surgery |
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| DOI：10.3969/j.issn.1009?6469.2019.10.034 |
| 中文关键词: 妇科外科手术 腹腔镜检查 体位 病人满意度 改良截石位 |
| 英文关键词: Gynecologic surgical procedures Laparoscopy Posture Patient satisfaction Modified lithotomy position |
| 基金项目:江苏省无锡市卫生计生委科研项目( MS201608) |
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| 中文摘要: |
| 目的探讨改良截石位对妇科腹腔镜手术病人手术时间、术中出血量及体位舒适度的影响。方法将 2015年 10月至 2016年 10月无锡市锡山人民医院收治的行传统截石位的妇科腹腔镜手术病人 48例作为对照组，再选取 2016年 11月至 2017年 11月该院收治的行改良截石位的妇科腹腔镜手术病人 48例作为观察组。对比两组手术时间、术中出血量、术中体位舒适度及体位相关并发症发生情况。结果观察组子宫全切术、子宫广泛切除术、输卵管再通术的手术时间分别为( 49.06±11.28) min、(140.27±23.81)min、(50.18±11.51)min，术中出血量分别为( 33.17±8.91)mL、(102.18±22.15)mL、(11.25±2.15)mL，均少于对照组［手术时间:(65.25±10.37)min、(185.27±26.55)min、(65.28±10.41)min，术中出血量:(46.12±10.54)mL、(144.28±25.71) mL、(17.38±2.83)mL］，差异有统计学意义( t＝7.321、8.742、6.741、6.501、8.595、11.950，均 P＜0.001)；观察组子宫次全切术、附件手术的手术时间、术中出血量与对照组比较，差异无统计学意义( P＞0.05)；观察组生理维度、心理维度、环境维度、社会文化维度及体位舒适度总评分分别为( 13.25±1.15)分、(25.14±4.07)分、(19.06±1.43)分、(18.82±1.41)分、(75.14±7.92)分，均高于对照组［(9.02±1.12)分、(20.15±2.97)分、(15.27±1.95)分、(15.24±1.52)分、(60.17±4.61)分］差异有统计学意义( t＝18.256、6.862、 10.859、11.963、11.318，均 P＜0.001)；观察组体位相关并发症发生率为 8.33%，低于对的 41.67%，差异有统计学意义( χ2＝照组，12.500，P＜0.001)。结论改良截石位应用于妇科腹腔镜手术病人效果优于传统截石位，可缩短手术时间，减少术中出血量和体位相关并发症发生，提高体位舒适度，值得推广。 |
| 英文摘要: |
| Objective To explore the effect of improved lithotomy position on operative time，intraoperative blood loss and position comfort in gynecological laparoscopic surgery.Methods Forty?eight patients with gynecological laparoscopic surgery who receivedtraditional lithotomy from October 2015 to October 2016 in Wuxi Xishan People's Hospital were used as control group.48 patientswith gynecological laparoscopic surgery were used as observation group.The operation time，intraoperative blood loss，intraoperativeposition comfort and position?related complications were compared between the two groups.Results The operation time of total hys? terectomy，extensive hysterectomy and fallopian tube recanalization in the observation group were(49.06±11.28)min，(140.27± 23.81)min，(50.18±11.51)min，and the intraoperative blood loss was(33.17±8.91)mL，(102.18±22.15)mL，(11.25±2.15)mL， which were less than those in the control group［surgical time:(65.25±10.37)min，(185.27±26.55)min，(65.28±10.41)min；intra? operative blood loss:(46.12±10.54)mL，(144.28±25.71)mL，(17.38±2.83)mL］，and the differences were statistically significant(t＝7.321，8.742，6.741，6.501，8.559 and 11.950，respectively，all P＜0.001).There was no significant difference in the operationtime and intraoperative blood loss of subtotal hysterectomy and adnexal surgery between the observation group and the control group(P＞0.05).The physiological，psychological，environmental，social cultural dimensions，and the total scores of position comfort of the observation group were(13.25±1.15)points，(25.14±4.07)points，(19.06±1.43)points，(18.82±1.41)points and(75.14± 7.92)points，respectively，which were higher than those in the control group［( 9.02±1.12)points，(20.15±2.97)points，(15.27± 1.95)points，(15.24±1.52)points and(60.17±4.61)points，respectively］，and the differences were statistically significant(t＝ 18.256，6.862，10.859，11.963 and 11.318，respectively，all P＜0.001)； the incidence of postural?related complications in the obser? vation group was 8.33%，which was lower than 41.67% of the control group，and the difference was statistically significant(χ2＝ 12.500，P＜0.001).Conclusion The improved lithotomy position is superior to traditional lithotomy in gynecological laparoscopic surgery，which can shorten the operation time，reduce the intraoperative blood loss and position?related complications，and improve the position comfort.It is worthy of promotion. |
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