可调试颈仰卧位在甲状腺手术中的应用效果观察

Application effect observation of adjustable cervical supine position in thyroid surgery

目的观察可调试颈仰卧位在甲状腺手术中的应用效果。方法将106例甲状腺手术患者按随机数字表分为观察组53例和对照组53例。对照组术中采用传统颈仰卧位安置,观察组采用可调试仰卧位安置。比较两组患者术中、术后相应的指标变化。结果体位安置时间对照组(2.6±1.0)min高于观察组(1.6±0.6)min,经比较,具有统计学意义(P<0.01)。两组患者在体位安置前、安置后10min内血流动力学变化不明显,但在体位安置后30min、60min两组患者的血压、心率出现上升,两两比较,具有统计学意义(P<0.05)。Ⅰ级术野暴露观察组高于对照组。两组术中导管意外事件比较,对照组5例,观察组未发生,x2=5.25,P<0.05。患者术后头痛发生率观察组显著低于对照组,x2=4.30,P<0.05,恶心呕吐的发生率显著低于对照组,x2=5.27,P<0.05,肩背部疼痛的发生率显著低于对照组比较,x2=7.36,P<0.01。结论甲状腺手术中可调试颈仰卧位明显优于传统体位安置方法,术中患者血流动力学变化相对稳定,节省体位安置时间及人力,并可降低术后并发症的发生率。

Objective To observe the effect of adjustable cervical supme posmon on thyroid surgery. /Vletlioa t）lvKle 106 patients undergoing thyroid surgery into ohservation group and control group equally by random number table. Patients in control group are in routine cervical supine position. Patients in observation group are in adjustable cervical supine posi- tion. Compare the change of related indexes in and after operation. Result Position placement time is longer in control group （2.6 ± 1.0） min than in observation group （ 1.6 ±0. 6） min. The difference is significant （P〈0. 01）. There is no obvi- ous change on hemodynamics before and 10rain after the position placement between two groups. But the blood pressure and heart rate all rise in two groups. The difference is significant （P〈0. 05）. Level I operative field is higher in observation group than in control group. There are 5 cases of catheter accidents in control group and none in observation group, x2 = 5.25,P〈0. 05. Incidence of headache after operation is obviously lower in observation group than in control group, x2 = 4. 30, P〈0. 05. Incidence of nausea and vomiting is obviously lower in observation group, x2 =5.27 ,P〈0. 05. Incidence of shoulder and back pain is obviously lower in observation group, x2 =7. 36,P〈0. 01. Conclusion Adjustable cervical supine position is obviously better than routine cervical supine position in thyroid surgery. There is more stable hemodynamic change, less position placement time and less manpower and lower incidence of post--operative complications in operation for patients.