体位干预对妇科腹腔镜术后腹腔引流量的影响

Influence of intraoperative posture intervention on drainage in patients after gynecological laparoscopic surgery

目的研究妇科腹腔镜术中体位干预对术后腹腔引流量的影响。方法选择2006年12月至2008年11月入住我院妇科病房并符合纳入标准的1250例接受腹腔镜手术的患者,包括6种术式(腹腔镜下双侧输卵管整形通液术、腹腔镜下卵巢囊肿剥出术、腹腔镜下异位妊娠诊治术、腹腔镜辅助下经阴道全子宫或加双附件切除术、腹腔镜下子宫肌瘤剥出术、腹腔镜下单侧或双侧附件切除术),将每种术式的患者随机分为研究组与对照组。研究组患者由巡回护士在手术医师吸净腹腔内残余液体前调整手术床位置,使患者从原来的头低臀高截石位调整为水平截石位或头稍高位置;对照组患者在手术结束后由巡回护士将手术床恢复水平位置。统计两组术后腹腔引流总量、置管天数、术后住院时间。结果6种术式的研究组和对照组相比,术后腹腔引流总量、置管天数、术后住院时间明显减少(除腹腔镜下单侧或双侧附件切除患者术后住院天数一项外),差异有统计学意义(P<0.05)。结论妇科腹腔镜术中体位干预有利于提高术后腹腔引流效果。

Objective To investigate the influence of intraoperative posture intervention on drainage in patients after gynecological laparoscopic surgery. Methods A total of 1250 patients who were scheduled for gynecological laparoscopic surgery including laparoscopic-assisted salpingoplasty,oophorocystectomy,ectopic pregnancy,vaginal hysterectomy,myomectomy and appendectomy were randomly divided into two groups. The patients＇ posture was changed from Trendelenburg position to level lithotomic position during suction by the circulating nurses in the experimental group,while after surgery in the control group. The volume and time of drainage,and the length of stay after surgery were compared between the two groups. Results The volume and time of drainage,as well as the length of stay after surgery had significant differences between the two groups （P0.05）.Conclusions Intraoperative posture intervention is helpful for the treatment effect of drainage after gynecological laparoscopic surgery.