侧卧位神经外科手术非受压侧上肢约束带的制作与应用

The manufacture and application of the non-compression upper limb restraint band in the lateral decubitus operation in Neurosurgery Department

目的为神经外科侧卧位手术患者非受压侧上肢设计一种有效、便利的约束带。方法2017年8月-2018年3月选取在河北医科大学第二医院手术室进行神经外科手术的侧卧位患者为研究对象，利用专业运动护肩、前臂护套、捆绑带、魔术贴等自制体位约束带。运用SPSS 22．0统计软件产生的随机数表将160例神经外科侧卧位手术患者分为对照组和观察组，各80例。对照组采用常规肩部约束带和腕部约束带，观察组使用自制侧卧位上肢约束带。观察两组手术患者在侧卧位摆放时间、非受压侧上肢皮肤压疮发生率和约束有效率方面的差异。结果对照组手术体位摆放时间为（365．97±42．08）s，非受压侧上肢皮肤压疮发生率为10．0％，高于观察组的体位摆放时间（302．69±38．25）s和非受压侧上肢皮肤压疮发生率1．3％，差异均有统计学意义（P〈0．05）。观察组非受压侧上肢约束有效率为100．0％，较对照组的91.3％提高，差异具有统计学意义（P〈0．05）。结论自制上肢约束带用于神经外科侧卧位手术患者可有效暴露手术野，提高患者舒适度，提高体位摆放效率和约束效率。

Objective To find an effective and convenient restraint band for the upper limb of the non-compression side for the patients in the lateral decubitus operation in the Neurosurgery Department. Methods From August 2017 to March 2018, patients in the lateral decubitus operation in the Neurosurgery Department, who from the Second Hospital of Hebei Medical University, were selected as the research objects. The self-made posture restraint belt was made of professional exercise shoulder, forearm sheath, binding band and magic stick. By using random number table produced by SPSS 22.0 edition, 160 patients who underwent lateral decubitus operation in the Neurosurgery Department were randomly divided into the control group and the observation group, with 80 cases in each group. In the control group, the conventional shoulder straps and wrist restraint bands were used, while the self-made lateral decubitus upper limb restraint band was used in the observation group. The differences of the time of lateral decubitus placement, the incidence of pressure sore in the non-compression side of the upper limb and the efficiency of restraint were observed and compared between the two groups. Results The time of lateral decubitus placement （365.97±42.08） s and the incidence of pressure sore in the non-compression side upper limb （10.0%） were higher than those of the observation group[（302.69±38.25）s, 1.3% ]. The differences were statistically significant （P 〈 0.05）. The efficiency （100.0%） of the non-compression side upper limb restraint in the observation group was higher than that in the control group （91.3%）. The difference was statistically significant （P〈0.05）. Conclusions The self-made upper limb restraint band for neurosurgery lateral position can effectively expose the surgical field, improve the comfort degree of patients, and improve the efficiency of posture placement and restraint.