90°斜侧卧位在后腹腔镜下泌尿外科手术中应用的效果观察

Clinical effect of oblique lateral decubitus position on retroperitoneal laparoscopic urological surgery

目的探讨90°斜侧卧位在后腹腔镜下泌尿外科手术中的应用效果,为临床提供一种有效降低皮肤压力性损伤发生率的手术体位。方法回顾性分析2023年9月至12月于本院泌尿外科收治的60例计划接受后腹腔镜手术的泌尿科患者,根据手术体位的不同,将患者分为对照组与试验组,每组分别30例。对照组患者采用传统90°正侧卧位实施手术,试验组患者采用90°斜侧卧位实施手术。比较两组患者术后受压部位皮肤压力性损伤发生率、术后24h腰背部疼痛程度、手术操作者的满意度评分。结果两组患者术后受压部位皮肤压力性损伤发生率、术后24h腰背部疼痛程度、手术操作者的满意度评分比较,均P<0.05,差异具有统计学意义,试验组患者术后受压部位皮肤压力性损伤发生率低于对照组,疼痛程度轻于对照组,手术操作者满意度评分高于对照组。采用Logistic回归分析控制人口学变量后两组患者术中压力性损伤发生风险结果显示,对照组发生风险是试验组的6.22倍。结论在后腹腔镜下泌尿外科手术中,采用90°斜侧卧位优于90°正侧卧位,可有效降低患者术中压力性损伤的发生率与减轻术后腰背部疼痛程度。

Objective To investigate the application and effectiveness of the 90°oblique lateral decubitus position in retroperitoneal laparoscopic urological surgery,providing a clinical approach to effectively reduce the incidence of pressure injuries on the skin.Methods A retrospective study was conducted on 60 urology patients who were admitted to the Department of Urology in our hospital from September to December 2023 for retroperitoneal laparoscopic surgery.The patients were divided into a traditional group and a trial group based on the surgical position,with 30 patients per group.A conventional 90°lateral decubitus position during surgery was applied to the patients in control group,while a 90°oblique lateral decubitus position was offered to the patients in trial group.The two groups were compared in terms of the incidence rate of skin pressure injury,lumbar back pain on the healthy side within 24 hours after surgery and the score of satisfaction from the surgical team.After controlling for demographic variables using logistic regression analysis,the risk of intraoperative pressure injury occurrence in the two groups of patients was found to be related to the group type.The risk of occurrence in the control group was 6.22 times that of the trial group.Results The observation group demonstrated a significantly lower incidence rate of postoperative skin pressure injury,a significantly lower postoperative lumbar back pain on the healthy side within 24 hours,and a significantly higher score in the surgical team satisfaction compared with those of the control group(all P<0.05).Conclusion In retroperitoneal laparoscopic urological surgery,the 90°oblique lateral decubitus position shows a superiority to the conventional lateral decubitus position in reducing the incidence rate of postoperative pressure injury and decreasing the lumbar back pain on the healthy side.