不同下肢摆放角度对俯卧位胸腰椎手术患者静脉回流的影响

Effects of different lower limb placement angles on venous drainage among patients undergoing thoracolumbar surgery in prone position

目的:探讨不同下肢摆放角度对俯卧位胸腰椎手术患者静脉回流的影响。方法:选择2017年1月—2018年1月北京医院手术室行择期俯卧位胸腰椎手术的患者作为研究对象,根据手术需要将其分为低角度组51例,传统角度组54例。以手术前后超声下下肢静脉血流变化为主要观察指标,以下肢皮温改变、腿围变化为次要观察指标,比较不同下肢摆放角度对患者的影响。结果:两组患者手术前后超声下左、右两侧腘静脉和左、右两侧胫后静脉的血流变化差异有统计学意义(P<0.05);两组患者左、右踝上10 cm腿围变化和左、右髌骨上15 cm腿围变化差异无统计学意义(P>0.05),两侧皮温变化差异也无统计学意义(P>0.05)。结论:俯卧位胸腰椎手术患者的下肢摆放角度可能影响其静脉回流,手术室护士在体位摆放时应当注意。

Objective To explore effects of different lower limb placement angles on venous drainage among patients undergoing thoracolumbar surgery in prone position.Methods From January 2017 to January 2018,we selected patients underwent elective thoracolumbar surgery in prone position of Operating Room in Beijing Hospital as research objects.According to the need of surgery,it was divided into 51 cases in low-angle group and 54 cases in traditional-angle group.We compared effects of different lower limb placement angles on patients by taking the changes of lower limb venous blood flow under ultrasound before and after surgery as main observation indicators and taking changes of lower limb skin temperature and leg circumference as the secondary observation indicator.Results There were statistical differences in the changes of blood flow on the left and right popliteal veins,the left and right posterior tibial veins of patients under ultrasound between two groups before and after surgery(P<0.05).There were no statistical differences in the changes of the leg circumference of 10 cm above the left and right ankles and the changes of the leg circumference of 15 cm above the left and right patellae of patients between two groups(P>0.05);there was also no statistical difference in the change of bilateral skin temperature(P>0.05).Conclusions The lower limb placement angles among patients undergoing thoracolumbar surgery in prone position may affect the venous drainage which nurses of Operating Room should pay attention to when placing positions.