摘要
目的探讨改良截石位对妇科腔镜手术患者术后并发症及下肢静脉血栓的影响。方法选取2021年5月至2022年3月于青海省人民医院收治的100例妇科腔镜手术患者。依据随机数字表法将患者分为常规组(术中采用常规截石位)和改良组(术中采用改良中凹截石位),各50例。比较两组患者的围手术期指标,包括体位摆放时间、手术时间、术中出血量,以及患者舒适度与满意度。比较两组患者体位摆放前(气腹建立后)、术后(术后恢复平卧位后5 min)的血流动力学指标[收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)]、眼压、呼吸指标[气道峰压(Ppeak)、经皮动脉血氧饱和度(SpO_(2))、呼气末二氧化碳分压(PetCO_(2))]及双侧股静脉血流速度(左股静脉血流速度、右股静脉血流速度)。比较两组患者术后下肢静脉血栓与其他并发症发生情况。结果改良组患者的体位摆放时间明显长于常规组患者,手术时间明显短于常规组患者,术中出血量明显低于常规组患者,舒适度、满意度评分均明显高于常规组患者(P<0.01)。术后,常规组患者的SBP、DBP、MAP、眼压、PetCO_(2)、Ppeak均高于改良组患者,SpO_(2)低于改良组患者(P<0.05)。改良组患者术后下肢静脉血栓及其他术后并发症的发生率低于常规组患者(P<0.05)。结论改良截石位不但可减轻妇科腔镜手术患者术中下肢受压程度,改善患者血流动力学,促进患者下肢血流,而且有利于手术操作,降低术后下肢静脉血栓及相关术后并发症的发生风险。
Objective To investigate the effect of improved lithotomy position on postoperative complications and lower extremity venous thrombosis in patients undergoing gynecological laparoscopic surgery.Method A total of 100 gynecological laparoscopic patients admitted to Qinghai Provincial People's Hospital from May 2021 to March 2022 were selected.The patients were divided into the conventional group(the conventional lithotomy position was used during the operation)and the improved group(the improved central concave lithotomy position was used during the operation)according to the random number table method with 50 cases in each group.The perioperative indicators including the positioning time,operation time,intraoperative blood loss,and patient comfort and satisfaction of the two groups of patients were compared.The hemodynamic indicators[systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP)],intraocular pressure,respiratory indexes[peak airway pressure(Ppeak),percutaneous arterial oxygen saturation(SpO_(2)),partial pressure of end-tidal carbon dioxide(PetCO_(2))]and bilateral femoral venous blood flow velocity(left femoral venous blood velocity,right femoral venous blood velocity)were compared before the postural placement(after the establishment of pneumoperitoneum)and after operation(5 minutes after the restoration of supine position after operation).The incidence of postoperative venous thrombosis of the lower extremity and other complications were compared between the two groups.Result The duration of postural placement of the improved group was significantly longer than that of the conventional group,the operation time was significantly shorter than that of the conventional group,the intraoperative blood loss was significantly lower than that of the conventional group,and the scores of comfort and satisfaction were significantly higher than those of the conventional group(P<0.01).After the operation,the SBP,DBP,MAP,intraocular pressure,PetCO_(2) and Ppeak of the conventional group were higher than those of the improved group,and the SpO_(2) was lower than that of the improved group(P<0.05).The incidence rate of postoperative lower extremity venous thrombosis and other postoperative complications in the improved group was lower than that in the conventional group(P<0.05).Conclusion The improved lithotomy position could not only reduce the degree of lower extremity compression in patients undergoing gynecological laparoscopic surgery,improve the patient’s hemodynamics,and promote the blood flow of the lower extremity,but also facilitates the surgical operation and reduces the risk of postoperative lower extremity vein thrombosis and relevant postoperative complications.
作者
崔冀芳
马丽萍
庞志萍
刘婷婷
魏志彬
陈娟
吴丽春
王婧
贺贝贝
Cui Jifang;Ma Liping;Pang Zhiping;Liu Tingting;Wei Zhibin;Chen Juan;Wu Lichun;Wang Jing;He Beibei(Department of Clean Operation,Qinghai Provincial People's Hospital,Xining 810007,Qinghai,China;Department of Vascular Surgery,Qinghai Provincial People's Hospital,Xining 810007,Qinghai,China)
出处
《血管与腔内血管外科杂志》
2022年第6期679-683,702,共6页
Journal of Vascular and Endovascular Surgery
基金
青海省卫生健康委指导性计划课题(2021-wjzdx-28)。
关键词
妇科
腔镜手术
截石位
静脉血栓
血流动力学
并发症
gynecology
laparoscopic surgery
lithotomy position
venous thrombosis
hemodynamics
complication
