新型侧俯卧体位垫的研制与手术中应用研究

Study on the development of a new type of lateral prone position cushionpad and its application in surgery

目的:研制一款新型侧俯卧体位垫,用于胆胰疾病患者内镜下逆行胰胆管造影(ERCP)侧俯卧位手术,以解决术中体位安置困难问题。方法:采用高密度加硬海绵、优质聚氨酯(PU)皮革等材料,用魔术贴组合;体垫由头垫模块、胸腹垫模块和下肢辅助垫模块构成,组合各模块研制成新型侧俯卧体位垫。选取在医院行侧俯卧位手术的54例胆胰疾病患者,按照随机数表法将其分为观察组和对照组,每组27例,对照组使用传统的体位垫固定,观察组使用新型侧俯卧体位垫固定,比较两组体位固定情况、皮肤受压状况、体位安置时间和医护人员的满意度。结果:新型侧俯卧体位垫的应用,凸显手术视野,便于手术操作,明显提高了工作效率,术中缩短了体位摆放时间,两组体位安置时间比较差异有统计学意义(t=32.37,P<0.05);两组术中体位固定、皮肤压红情况比较差异有统计学意义(x^(2)=22.519,x^(2)=35.901;P<0.05);两组术中和术后医护人员的满意度比较,差异有统计学意义(x^(2)=4.418,P<0.05)。结论:新型侧俯卧体位垫结构设计科学,符合手术操作需求,操作方便、安全、舒适,有利于胆胰疾病患者进行ERCP侧俯卧体位的摆放,具有临床应用价值。

Objective:To research a new type of lateral prone position cushion which could be used in the patients with pancreaticobiliary diseases who underwent Endoscopic Retrograde Cholangiopancreatography(ERCP)surgery with lateral prone position,so as to solve the problem of difficult position arrangement during operation.Methods:The hardened sponge with high density,the polyurethane(PU)with high quality and others were adopted,and the magic paste was used to assemble them.The body cushion was composed of a head cushion module,a chest and abdomen cushion module and an assistant cushion module of lower limb,and the new type of lateral prone position cushion was developed by combining above each module.Fifty-four patients with pancreaticobiliary diseases who underwent surgery with lateral prone position were selected and were divided into observation group and control group according to the random number table,with 27 cases in each group.The control group adopted traditional position cushion to fix body,and the observation group adopted the new type of lateral prone position cushion to fix body.And then the situations of position fixation,pressured skin and placement time of position,and the satisfactions of medical staffs between two groups were compared.Results:The application of new type of lateral prone position cushion could highlight the visual field of surgery,and was convenient for the operation of surgery,and significantly improved the working efficiency and shortened the placement time of body position in the surgery.And the differences of working efficiency and placement time between two groups were significant(t=32.37,P<0.05).There were significant differences in the situations of the fixation of body position and skin redness with pressure between the two groups(x^(2)=22.519,x^(2)=35.901,P<0.05).And the differences of intraoperative and postoperative satisfactions of medical staffs between two groups were statistically significant(x^(2)=4.418,P<0.05).Conclusion:The design of the structure of new type of lateral prone position cushion is scientific,which can meet the requirements of surgical operation,and which operation is convenient,safe and comfortable,and which is helpful for the placement of ERCP lateral prone position of patients with pancreaticobiliary diseases.It has clinical application value.