肾脏手术患者升桥侧卧位适宜腰桥角度的研究

Study on suitable waist bridge angle for patients undergoing kidney operation in lateral position heightening the waist bridge

目的探讨肾脏手术患者升桥侧卧位适宜的腰桥角度,确保手术患者的体位安全。方法将60例安置升桥侧卧位行肾脏手术患者随机分为对照组和干预组各30例。两组术前均按常规安置升桥侧卧位,对照组腰桥角度安置为100~120°,干预组腰桥角度安置为121~140°。结果两组术中尿量异常及血尿发生率比较,差异无统计学意义（均P〉0.05）;两组健侧腰部皮肤压疮发生率比较,差异有统计学意义（P〈0.05）;两组血肌酐、血钾和肌红蛋白水平比较,干预效应、时间效应及交互效应差异有统计学意义（P〈0.05,P〈0.01）。两组肌酸激酶水平干预效应差异无统计学意义（P〉0.05）。结论肾脏手术患者升桥侧卧位适宜的腰桥角度为121~140°,在充分暴露术野方便医生操作的同时,可提高手术患者的安全性和舒适性。

Objective To explore the suitable waist bridge angle for patients undergoing kidney operation in lateral position heightening the waist bridge, and to ensure patientsrposition safety. Methods A total of 60 patients undergoing kidney operation in lateral position heightening the waist bridge were randomized into a control group and an intervention group, with 30 patients in each group. All patients in the two groups were placed in lateral position heightening the waist bridge using routine steps, waist bridge angle for the control group was 100-120°, while it was 121-140° for the intervention group. Results There were no significant differences in abnormal urine volume and incidence of hematuria during operation between the two groups （P〉0.05 for both）, while there was significant difference in prevalence of skin pressure ulcer in the non-surgical waist after operation between the two groups （P〈0.05）, and when compared with blood creatinine, Kalemia and myohemoglobin, there were significant differences in intervening effect, time effect and interaction effect between the two groups （P〈0.05 ,P〈0.01） , while there was no significant difference in creatine kinase between the two groups （P〉0.05）. Conclusion The suitable waist bridge angle for patients undergoing kidney operation in lateral position heightening the waist bridge is 121-140°, which could provide full exposure of operation field that convenient for surgeon, and improve patients＇safety and comfort.