俯卧位下地心引力及机械性干涉对脊柱手术循环动力影响的临床研究

Gravitational and Mechanic Interference on the Hemodynamics during Spinal Operation in Prone Position

作者研究了３６例俯卧位脊柱手术患者在翻转体位期间地心引力及机械干涉对循环动力的影响。结果表明，常规先麻醉后将患者置于手术体位者，其血流动力（ｓｙｓｔｏｌｉｃｂｌｏｏｄｐｒｅｓｓｕｒｅ，简为ＳＢＰ；ｈｅａｒｔｒａｔｅ，简为ＨＲ）波动极为明显（Ｐ值＜０．０１），若改为先将患者置于手术体位，再注入麻醉药物，其血流动力波动则比较平稳（Ｐ值＞０．０５）。由此作者提出：（１）此类手术应先将患者置于手术体位，再麻醉；（２）对体质极差者，不应将患者安置在超过忍受限度的强迫体位上；（３）安置体位时应取锁骨和髂骨作为支点．

AbstractThe authors investigated the effects of positionchange on the hemodynamics of 36 cases of spinal ope-rations done in the prone position,The results showedthat,if the patient was placed on the operation posi-tion following the administration of the anesthesia, thechanges of herriodynamics(SBP,HR )were significant(P<0.01,0.05).On the contrary,if the patient wasplaced in the operation position and then started theanesthesia,the hemodynamic changes were comparatively stable,The authors conclt1dedthat,(1)for thecases undergoing spinal operations,it is advisable toplace the patient in the operation position at first andthen start the anesthesia:(2)for the critical cases,atolerable position should be adopted;(3)during theadjustment of the position of the patient,the clavicleand the ilium should be used as the fulcrum so as toavoid direct contact of the chest and abdomen with theoperation table,thus to minimize interference on thehemodynamics.