改良侧卧位在手术体位中的应用

目的探讨常规侧卧手术体位摆放的改进与应用效果。方法将160例侧卧手术患者随机分为改良组与传统组两组，每组为80例。传统组采用第四版《医疗护理技术操作常规》方法摆放。改良组：麻醉前胸壁下方垫一小软枕，麻醉后根据病变位置选择左侧或右侧卧位，双手曲置面前呈睡眠状，两手臂之间垫一小软枕；两腿前后分开，上腿屈膝，下腿伸直；头部垫高后再将耳廓置于头圈空隙处；胸腹部及背部各固定一圆柱纱袋，最后用缚带固定髋部、膝部。分别观察两组体位摆放平均完成所需时间、术中体位移动发生率、术后皮肤组织受压以及术后随访肢体疲劳、神经损伤等情况。结果改良组摆放法平均完成时间短于传统组，皮肤组织受压、肢体疲劳、神经损伤术后并发症发生率也明显低于传统组，组间比较差异具有统计学意义[（13．97±1．63）vs（6．71±12．9），t=31．238，P〈0．01；）x2=6．8267，8．9011，11．7566，P〈0．01）。结论采用改良侧卧摆放法可缩短摆放时间，对BP、HR、SpO2、呼吸次数改变没有明显影响，而且可以明显降低因体位摆放不当而引起的并发症，能进一步提高手术护理质量。

Application of the improved lateral decubitus position in the operation

Objective To explore the application effect of the improved lateral decubitus position in the operation.Methods 160 cases were randomly divided into the modified lateral surgical group and traditional group two groups (n =80 for each group).Fourth edition of the traditional group was “routine medical care and technical operations” approach placed.Modified group:before anesthesia,a small pad under the chest wall soft pillow,according to lesion location after anesthesia choose left or right lateral position,his hands in front of music was set to sleep like the two arms of a small soft pillowbetween the pad; Front legs apart,on the tuiqu Xi,the next leg straight; head elevated after the first lap put the gap at the ear; Chest and abdomen and the back of each fixed a cylindrical yam bags,and finally tied with fixed hip,knee.Placed in two groups were observed an average completion time position,the incidence of intra-operative movement position,pressure and skin after postoperative follow-up physical fatigue,nerve damage,etc.Results Placed in modified group method average completion time is shorter than the traditional group,skin pressure,body fatigue,nerve injury rate of postoperative complications was significantly lower than the traditional group,intra-operative position more stable than the traditional group [ ( 13.97 ± 1.63 ) vs (6.71 ± 12.9 ),t =31.238,P ＜ 0.01 ; x2 =6.826 7,8.901 1,1 1.756 6,P ＜ 0.01 ).Conclusions Placed by the improved method can shorten the display side of time.For BP,HR,SpO2,respiration rate change had no effect,and complications of place due to improper posture can be significantly reduced and further enhance the quality of surgical care.