比较两种手术体位在吻合器环形痔切除术中的效果

目的比较截石位和折刀位在吻合器环形痔切除术(procedure for prolapse and hemorrhoids,PPH)中的应用效果,为临床PPH手术体位摆放提供依据。方法选择2006年12月-2009年12月在本科室行PPH手术的患者200例,随机分为对照组和实验组各100例。实验组手术过程摆放折刀位,对照组手术过程摆放截石位。比较两组患者手术时间,术中出血量,臂丛神经损伤、皮肤压红、体位性低血压发生率及医护患满意度。结果实验组患者手术时间短于对照组、术中出血量少于对照组、体位性低血压及皮肤压红发生率低于对照组、医护患满意度高于对照组(均P<0.05﹚;臂丛神经损伤情况比较,差异无统计学意义(P>0.05)。结论折刀位是一种适合PPH手术的体位,可以缩短手术时间,减少术中出血量,提高医护患满意度。

Objective To explore the effect of lithotomy position and clasp knife position on the operative effect of procedure for prolapse and hemorrhoids （PPH） so as to provide a basis for a selection of proper position during PPH. Methods 200 patients admitted from Oct. 2006 to Dee. 2009 in our department were equally randomized into the control group and the experimental group： the former group took lithotomy position and the latter clasp knife position. The operation duration, total amount of bleeding, nerve injury, the incidence of hypotension and redden skin after operation and degree of doctor-patient satisfaction were compared between the two groups. Results The patients in the experimental group had shorter operation duration, less amount of bleeding during operation, lower incidence of low blood pressure and redden skin after operation, and much higher degree of doctor-patient satisfaction （P 〈 0.05）, compared to the control group. There was no significant difference between the two groups in nerve damage （P 〉 0.05）. Conclusion Clasp knife position is more suitable for PPH operations because it can shorten the operation duration, reduce the total amount of bleeding and increase degree of doctor-patient satisfaction.