改良侧卧位固定在食管癌手术患者中的应用效果

Application effects of modified lateral position fixation in patients with esophageal cancer surgery

目的:观察改良侧卧位固定在食管癌手术患者中的应用效果。方法:选取2020年11月至2022年10月该院收治的86例食管癌患者进行前瞻性研究,采用抽签法将其分为对照组和观察组各43例。对照组术中予以传统侧卧位固定,观察组术中予以改良侧卧位固定,比较两组术中视野暴露评分、手术时间、体位安置时间、不良事件发生率,体位安置前、安置3 min后舒张压(DBP)和收缩压(SBP)水平,以及医师满意度。结果:观察组术中视野暴露评分高于对照组,体位安置时间和手术时间均短于对照组,差异有统计学意义(P<0.05);观察组不良事件发生率为0,低于对照组的13.95%(6/43),差异有统计学意义(P<0.05);体位安置3 min后,两组DBP、SBP水平均高于体位安置前,但观察组低于对照组,差异有统计学意义(P<0.05);观察组医师满意度为97.67%(42/43),高于对照组的81.40%(35/43),差异有统计学意义(P<0.05)。结论:改良侧卧位固定应用于食管癌手术患者可提高术中视野暴露评分和医师满意度,缩短体位安置时间和手术时间,降低体位安置3 min后DBP、SBP水平和不良事件发生率,效果优于传统侧卧位固定。

Objective:To observe application effects of modified lateral position fixation in patients with esophageal cancer surgery.Methods:A prospective study was conducted on 86 patients with esophageal cancer admitted to the hospital from November 2020 to October 2022.They were divided into control group and observation group by using the lottery method,43 cases in each group.The control group was fixed in the traditional lateral position during the surgery,while the observation group was fixed in the modified lateral position during the surgery.The intraoperative visual field exposure score,the operation time,the position placement time,the incidence of adverse events,the diastolic blood pressure(DBP)and systolic blood pressure(SBP)levels before and 3 min after position placement,and the physician satisfaction were compared between the two groups.Results:The intraoperative visual field exposure score in the observation group was higher than that in the control group,the position placement time and the operation time were shorter than those in the control group,and the differences were statistically significant(P<0.05).The incidence of adverse events in the observation group was 0,which was lower than 13.95%(6/43)in the control group,and the difference was statistically significant(P<0.05).After 3 minutes of position placement,the levels of DBP and SBP in the two groups were higher than those before position placement,but those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Further,the physician satisfaction in the observation group was 97.67%(42/43),which was higher than 81.40%(35/43)of the control group,and the difference was statistically significant(P<0.05).Conclusions:The modified lateral position fixation in the patients undergoing esophageal cancer surgery can improve the intraoperative visual field exposure scores and the physician satisfaction,shorten the position placement time and the operation time,and reduce the fluctuation DBP and SBP levels and the incidence of adverse events after 3 min of placement.Moreover,it is superior to single the traditional lateral position fixation.