一种新型肩部牵拉带的研制及应用

Development and application of a new type of shoulder pull belt

目的介绍一种新型肩部牵拉带的设计理念及制作方法，并对其临床应用效果进行观察研究。方法2013年11月-2014年1月选取实施侧颅底或颈椎手术患者40例作为对照组．使用绷带牵拉固定法；选择2014年2—4月实施侧颅底或颈椎手术患者40例作为观察组．使用新型肩部牵拉带法。通过使用不同的方法进行牵拉固定，评价两组新型肩部牵拉带的使用效果。结果观察组在手术前摆放体位的操作时间平均为5．3min，少于对照组的13．2min。观察组出现上肢麻木、肩部压痕、水泡、因绷带固定不到位需重新摆放或再次固定体位的比例低于对照组，差异有统计学意义（P〈0．05）。观察组肩部牵拉固定效果、压疮防护效果、手术野暴露效果优秀率均高于对照组，差异有统计学意义（P〈0．05）。观察组患者舒适满意度及医生满意度均高于对照组，差异有统计学意义（P〈0．05）。结论新型肩部牵拉带比传统绷带牵拉固定法能够提升患者舒适度，最大限度减少压疮的发生，减轻医护人员工作强度，提高手术效率，值得临床推广使用。

Objective To introduce the design concept and making methods of a new type of shoulder pull belt, and observe the clinical application effects.Methods 40 patients with lateral skull base and cervical spine surgery from November 2013 to January 2014 were selected as the control group and were given bandage pull fixed method, while 40 patients with lateral skull base and cervical spine surgery from February 2014 to April 2014 were selected as the observation group and were given new shoulder pull method, and evaluated the effects of two new shoulder pull belts through using different traction and fixation methods. Results The operation time of setting body position before surgery in the observation group was 5.3 min on average, and it was significantly less than the Control group for 13.2 minutes; The proportion of numbness of upper limb, shoulder indentation, blisters, need to rearrange or fixed position once again in the observation group were lower than the control group, with statistically significant differences （P〈0.05）. The assessment as ＂good effect＂ of shoulder stretch, pressure ulcer prevention, operative field exposure of the observation group were significantly higher than the control group（P〈0.05）.Conclusions New shoulder pull belt is better than traditional bandage pull fixed method. It can improve the comfort degree of patients; minimize the incidence of pressure ulcer; reduce the work intensity of medical personnel and improve the operation efficiency. It is worthy of clinic use.