经乙状窦后入路听神经瘤切除术患者改良侧俯卧位的效果观察

Effect of Modified Lateral Prone Position in Acoustic Neuroma Resection via Retrosigmoid Approach

目的探讨改良侧俯卧位在乙状窦后入路听神经瘤切除术患者中的应用效果。方法选取我院收治经乙状窦后入路听神经瘤切除术患者46例,按随机数表法分为对照组和观察组,每组各23例。对照组采用传统方法安置侧俯卧位,观察组采用改良侧俯卧位。观察2组患者手术体位安置时间、术后6 h受压侧肩峰皮肤压疮及术后6 d内肩臂酸痛、上肢麻木发生率。结果观察组手术体位安置时间短于对照组,观察组术后6 h受压侧肩峰皮肤压疮发生率低于对照组(P<0.05),观察组术后6 d内肩臂酸痛、上肢麻木发生率低于对照组(P<0.05)。结论经乙状窦后入路听神经瘤切除术患者采用改良侧俯卧位,手术体位安置时间较短,术后受压侧肩峰皮肤压疮、肩臂酸痛、上肢麻木发生率较低,同时保证患者手术中舒适与安全。

Objective To explore the effect of modified lateral prone position in acoustic neuroma resection via retrosigmoid approach, and to explore its comfort and safety. Methods Forty-six patients receiving acoustic neuroma resection were randomly divided into control and experiment group by random number table method with 23 patients in each group. In control group we set traditional lateral prone position, and modified lateral prone position in experiment group. Then we observed setting duration, pressure sores within 6 hours after operation and shoulder ＆ arm pain, upper extremity numbness within 6 days after operation between two groups. Results There was significant difference in position setting duration between two groups （P〈0.05）. The rate of stage I pressure sores on acromion in experiment group was lower than that of control and the difference was statistically significant （ P〈0.05）. The difference in situation of shoulder ＆ arm pain, upper extremity numbness within 6 days after operation between two groups was statistically significant （P〈0.05）. Conclusion It is convenient for nurses and surgeries to set modified lateral prone position in acoustic neuroma resection via retrosigmoid approach, which benefits patients ’ comfort and safety and the prevention of adverse events induced by postures.