人字型平卧位对阴式全子宫切除患者术中血压心率的影响

Effect of Type Supine Position on Blood Pressure and Heart Rate of Patients Undergoing Vaginal Total Hysterectomia

目的观察人字型平卧位对阴式全子宫切除术患者术中血压和心率的影响,寻求更舒适安全的手术体位。方法2005年8月-2007年7月妇科阴式全子宫切除术患者76例,按手术先后顺序编号,依编号进行分组,单号为对照组,双号为观察组,每组38例。对照组患者采取截石位;观察组患者取人字型平卧位,即两侧髋关节外展,双下肢水平分开100°～110°。术中监测两组患者心率、无创血压情况及术后下肢神经损伤等临床症状。结果对照组较观察组血压、心率波动明显,发生下肢疼痛、麻木症状例数多于观察组(P<0.05);观察组体位安置方便,术中手术野暴露满意。结论人字型平卧位可在一定程度上稳定和改善患者循环系统功能,减少下肢神经血管损伤,有效地提高手术的安全性。

Objective To explore the effect of type supine position on blood pressure and heart rate of patients undergoing vaginal total hysterectomia so as to find a more comfortable and safer body position for operation.Methods 76 patients undergoing vaginal total hysterectomia from Aug.2005 to Jul.2007 were equally grouped according to their registration numbers： those with odd numbers were in control group and those with even ones in observation group.The controls took the lithotomy position and those in the observation group type supine position,with their bilateral coxa abducted and both lower limbs separated to 100°-110°.The intraoperative monitoring of heart rate,blood pressure and the postoperative clinical symptoms like nerve injure were recorded and compared between the two groups.Results The alterations of blood pressure and heart rate in the control group were significant than those in the observation group（P〈0.05）.The number of controls suffering pains and numbness in lower limbs was significantly larger than that of those from the observation group（P〈0.05）.Conclusion Type supine position may improve the functions of circulation system in the patients to some extent,reduce nerve injure of lower limbs and effective enhance the operative safety.