可控式侧俯卧位在胸腔镜食管癌根治术中的应用

Application of modified controllable lateral prone position in thoracoscope resection of esophageal carcinoma

目的：探讨可控式侧俯卧位在人工气胸胸腔镜食管癌手术中的应用效果。方法于2011年12月—2013年12月将200例需进行食管癌根治术患者随机分为观察组和对照组,每组100例,观察组采用可控式侧俯卧位进行手术,对照组采用传统侧卧位进行手术。观察两组患者皮肤受压情况、手术野暴露程度、麻醉费用及医生满意度等并进行比较。结果观察组患者皮肤并发症发生率、手术时间、麻醉费用分别为4.0%、（78±20）min、（1812±490）元,均低于对照组,差异有统计学意义（χ^2/t值分别为4.348,-13.929,-3.683；P〈0.05）；观察组医生满意度为99%,高于对照组的93%,差异有统计学意义（χ^2=4.688,P〈0.05）。结论可控式侧俯卧位应用于人工气胸胸腔镜食管癌根治术能充分暴露手术野,缩短手术时间,使患者安全舒适,减少皮肤并发症,减少麻醉费用,值得临床推广应用。

Objective To investigate the effect of modified controllable lateral prone position in thoracoscope resection of esophageal carcinoma. Methods From December 2011 to December 2013, 200 cases of esophageal cancer patients treated by thoracoscope resection were randomly divided into observation group and control group, with 100 cases each. Observation group adopted the modified controllable lateral prone position, and the control group was given the traditional lateral position. The different postures of the skin pressure situation, operation field exposure, anesthesia cost and doctors′ satisfaction and so on were compared between two groups. Results The incidence of skin complications, operation time, anesthesia cost in the observation group were 4. 0%, （78 ± 20） min and （1812 ± 490） RMB, respectively, which were significantly lower than those in the control group （χ^2/t=4. 348,-13. 929,-3. 683, respectively;P〈0. 05）. The doctor satisfaction of the observation group was 99% which was significantly higher than 93% of the control group （χ^2 =4. 688, P〈0. 05）. Conclusions The modified controllable lateral prone position can fully expose the operation field during thoracoscope resection of esophageal carcinoma, reduce the operation time, make sure patients safety and comfort, reduce the skin complications, decrease the cost of anesthesia, so it is worthy of clinical popularization and application.