对传统颈椎前路手术体位改进的探讨

目的探讨对颈椎前路手术体位摆放方法的改进及其应用价值。方法将82例颈椎前路手术患者随机分成改进组与传统组两组,每组41例。传统组采用传统方法摆放。改进组病人半卧手术床上,肩部对应手术床活动头版连接处,全麻插管后将手术床摇成头高足低20°,再将头版下折至颈部充分暴露,同时在病人膝下放一软枕,双膝略屈。分别观察：摆放体位所需时间;摆放时对病员血压、心率的影响。结果改进组手术体位摆放时间明显短于传统组（P〈0.01）;两组患者摆放前后的血压、心率改变不明显（P〉0.05）。结论改进颈椎前路手术体位的摆放方法可缩短传统方法的摆放时间,且对血压、心率没有明显影响,值得临床推广应用。

Discussion about improving body position in traditional anterior cervical surgery

Objective To discuss the ways to improve the body position in anterior cervical surgeries and its clinical value.Method 82 patients of anterior cervical surgery were divided into two groups： the improvement group and the traditional group.Each group contained 41 patients.The patients of the traditional group were treated with the traditional way.The patients of the improvement group recline on bed with one shoulder in contact with the joint of the movable cephalic plate of the operating bed.After general anesthesia and intubation the operating bed was higher at the head end and lower at the foot end,forming a 200 angle,then bend down the cephalic plate till the neck was fully exposed.At the same time,soft pillow was beneath the patient＇s knees which shall be slightly bent.Results The time spent in finding the body position in the improvement group was obviously shorter than that in the traditional group（P〈0.01）.The changes in blood pressure and heart rate prior to and in the aftermath of putting the patients of the two groups were not noticeable（P〈0.05）.Conclusion Improving the way of putting the body in the right position in anterior cervical surgeries can reduce the time of putting spent in the traditional way and has no major impact to blood pressure and heart rate.