蜘蛛臂气动肢体定位装置在沙滩椅位肩关节镜手术中的应用

Analysis of the application of SPIDER limbs positioning device in arthroscopic surgery on shoulder joint of beach chair position

目的探讨在沙滩椅体位肩关节镜手术中应用蜘蛛臂气动手术定位系统（SPIDER）在肢体定位装置的临床效果。方法2009年8月至2010年8月对我院18例肩袖损伤患者进行关节镜下肩关节探查、肩袖缝合手术，其中9例患者在标准沙滩椅手术体位下进行手术，9例采用沙滩椅体位联合SPIDER肢体定位装置摆置手术体位，术后对两组患者的术前体位摆置时间、手术操作时间、医生对手术体位满意度和术后并发症进行随访分析。结果术前体位摆置时间：标准沙滩椅位平均（27．0±6．7）min，沙滩椅体位联合SPIDER肢体定位装置平均（31．0±7．9）min，两组比较差异无统计学意义（t=-1．158，P〉0．05）；手术操作时间两组分别为（78．2±12．7）min和（66．2±15．4）min，沙滩椅体位联合SPIDER肢体定位装置组较前者短，但组间比较差异无统计学意义（t=1．803，P〉0．05）；沙滩椅体位联合SPIDER肢体定位装置组医生对手术体位满意度为88．9％，而标准沙滩椅位组为77．8％；两组患者均未发生与手术体位相关的并发症。结论SPIDER肢体定位装置在沙滩椅体位肩关节镜手术中允许外科医生在手术过程中在无菌区域自行进行复杂的位置变化，对手术体位的满意度高，具有较好的实用性、先进性、科学性，值得临床推广应用。

Objective To investigate the clinical application effect of SPIDER limbs positioning device in arthroscopic surgery of beach chair position. Methods From August 2009 to August 2010 in our hospital 18 cases of patients with rotator cuff injury in shoulder were collected and treated with arthroscopic exploration and suturing operation, including 9 patients in the standard beach chair position under surgical operation, 9 cases of beach chairs position combine with SPIDER Limb positioning device. Follow up on the preoperative position placement time, operating time, doctors＇ satisfaction of surgery posture and postoperative complications. Results The preoperative placement position time of standard beach chair with a mean （27 ± 6.7） min, beach chair position combined with SPIDER limb positioning device with a mean （31 ±7.9）min, the two groups were no significant differences （ t =- 1. 158, P 〉 0. 05 ） ; the operation time of two groups were （78.2 ± 12.7 ） min and （66.2± 15.4） min, beach chair position combined with SPIDER limb positioning device group compared with the former was short,there was a between the two groups significant difference; doctors＇ surgery position satisfaction were 77.8% and 88.9% respectively, and there was no complications occurred related with posture. Conclusions SPIDER limb positioning device in the beach chair position in shoulder arthroscopy allows surgeon change positions of limbs during the operation in the sterile yea. It has high satisfaction with the surgical posture, practicability, advanced and worthy of clinical application.