抽真空塑型垫在胸科手术患者侧卧位安置中的应用

Application of vacuum modelling pad for lateral position in thoracic surgery

目的探讨抽真空塑型垫安置胸科手术患者侧卧位的应用效果,为患者及医护人员提供更方便舒适的体验.方法2017年5月-2018年3月随机选取100例在中山大学肿瘤医院手术室全麻下安置侧卧位行胸科手术的患者,按照随机数字表法分为观察组和对照组,每组50例,观察组采用聚氨酯抽真空塑型垫安置体位,对照组使用沙袋挡板等用物进行固定安置.记录两组患者体位安置时间、皮肤受压水疱发生情况,术毕发放问卷调查收集医护人员对体位的满意度,术后24 h内随访调查患者舒适度.结果观察组体位安置时间为(183.56±10.36)s,少于对照组的(290.80±14.71)s,差异有统计学意义(P<0.01);观察组皮肤压红11例,水疱2例,对照组皮肤压红24例,水疱9例,差异均有统计学意义(P<0.05);患者的体位舒适度评分观察组(6.72±0.39)分,高于对照组的(6.02±0.44)分,差异有统计学意义(P<0.01).在操作便利、站位舒适、患者安全和总体评价4项,观察组得分高于对照组,差异有统计学意义(均P<0.01);在术野暴露及固定效果方面,差异无统计学意义(均P>0.05).结论塑型垫用于胸科手术患者侧卧位安置既能更好地保护患者的生理功能,防止器官和皮肤损伤,保证患者安全,又能简化操作流程,站位更舒适,提高工作效率和医护人员的满意度.

Objective To investigate the feasibility and safety of vacuum modelling pad for patients with lateral position in thoracic surgery to improve the convenience and comfortable experience for medical staff and patients.Methods From May 2017 to March 2018,100 patients who underwent thoracic surgery under general anesthesia with lateral position in the operating room of Sun Yat-sen University Cancer Center were randomly selected and divided into observation group(n=50)and control group(n=50)according to random number table.The polyurethane vacuum modelling pad was used for to secure the patients'position in the observation group,while the sand bag baffle was used to secure the patient's position in the control group.Position placement time and skin pressure blisters were recorded in both groups.Questionnaires were sent out after operation to collect the satisfaction of medical staff with this position.The patients'comfort was followed up within 24 hours after operation.Results The position placement time in the observation group was(183.56±10.36)s,shorter than the control group with(290.80±14.71)s and the difference was statistically significant(P<0.01);there were 11 cases of skin reddening under pressure and 2 cases of blister in the observation group,which is statistically different from the control group with 24 cases of skin reddening under pressure and 9 cases of blister(P<0.05).Patients'comfort score was(6.72±0.39)in the observation group,higher than the control group with(6.02±0.44)and the difference was statistically significant(P<0.01).In terms of the 4 items of"the convenient operation","comfortable standing position","patient safety"and"overall evaluation",the observation group scored higher than the control group with statistical differences(P<0.01);in terms of the"surgical field exposure"and"fasten effects",there was no statistical difference(P>0.05).Conclusions The use of modelling pad for patient lateral position in thoracic surgery can not only prevent organ and skin damage and ensure patient safety,but also simplify the operation procedure,improve the comfort of standing position and the working efficiency and satisfaction of the medical staff.