单鼻腔经蝶垂体瘤切除术蝶鞍体表定位与手术头位关系的研究

目的探讨单鼻腔经蝶垂体瘤显微手术蝶鞍体表定位与最佳手术头部体位的关系。方法对18例MRI确诊的垂体瘤病人行单鼻腔经蝶垂体瘤显微手术,术前用"C"臂X光机进行蝶鞍体表定位,探讨OM线与蝶鞍体表定位的关系,并由此确定手术最佳头部体位。结果经上述确定的头部体位可确保双瓣鼻窥器垂直插入直达蝶窦前壁且可直至暴露双侧蝶窦开口,减少鼻腔区手术创伤并使手术经过顺利。结论术前蝶鞍体表定位后所确定的头位可使单鼻腔直接经蝶垂体瘤切除手术直视视野达最大,减少创伤,使手术更为顺利。

使用改良式托取胎头法治疗头位剖宫产术中胎头高浮的效果

目的:探讨使用改良式托取胎头法治疗头位剖宫产术中胎头高浮的效果。方法:选取2019年3月至2020年10月期间在广东省惠州市博罗县人民医院进行剖宫产手术的60例产妇作为研究对象。这些产妇的胎位均为头位,且在术中发生胎头高浮。随机将这些产妇分为对照组和观察组。为对照组产妇使用手入宫腔取胎头法进行治疗,为观察组产妇使用改良式拖取胎头法进行治疗。然后观察两组产妇治疗的效果。结果:治疗后,观察组产妇子宫切口撕裂的发生率及产褥期并发症的发生率均低于对照组产妇,其术中的出血量少于对照组产妇,其胎头娩出的时间短于对照组产妇,其所娩新生儿出生后1 min及5 min的阿氏评分法(Apgar)评分高于对照组产妇所娩新生儿,观察组产妇及其家属对治疗的总满意率高于对照组产妇及其家属,P<0.05。结论:使用改良式托取胎头法治疗头位剖宫产术中胎头高浮可减少产妇术中的出血量,促进其快速娩出胎头,降低其子宫切口撕裂及产褥期并发症的发生率,在一定程度上避免其所娩新生儿发生窒息,且产妇及其家属对治疗的满意度较高。

基于患者角色体验的体位管理模式在妇科头低脚高截石位手术中的应用效果分析

探究角色体验的体位管理模式在妇科头低脚高截石位手术中的应用效果。方法 选择2021年1-6期间在我院手术室就职的50名护士为研究对象,采用电脑盲选法分为两组各有25名护理人员。对照组采用常规体位管理培训,观察组采用角色体验的体位管理模式,对比两组手术体位摆放满意度。选择同期在我院妇科进行手术治疗的100例患者,对两组术中体位管理模式的舒适度进行评价。结果 观察组手术体位摆放满意度较高、舒适度评分较高(P<0.05)。结论 妇科截石位手术的体位管理护理中,安排护士进行角色体验的体位管理模式,能提升体位摆放满意度和患者舒适度。

Outcome of bone marrow instillation at fracture site in intracapsular fracture of femoral neck treated by head preserving surgery

Purpose： The aim of present study is to evaluate the outcome of bone marrow instillation at the fracture site in fracture of intracapsular neck femur treated by head preserving surgery. Methods： This study included 32 patients of age group 18e50 years with closed fracture of intracapsular neck femur. Patients were randomized into two groups as per the plan generated via www.randomization.com. The two groups were Group A （control）, in which the fracture of intracapsular neck femur was treated by closed reduction and cannulated cancellous screw fixation, and Group B （intervention）, in which additional percutaneous autologous bone marrow aspirate instillation at fracture site was done along with cannulated cancellous screw fixation. Postoperatively the union at fracture site and avascular necrosis of the femoral head were assessed on serial plain radiographs at final follow-up. Functional outcome was evaluated by Harris hip score. Results： The average follow-up was 19.6 months. Twelve patients in each group had union and 4 patients had signs of nonunion. One patient from each group had avascular necrosis of the femoral head. The average Harris hip score at final follow-up in Group A was 80.50 and in Group B was 75.73, which was found to be not significant. Conclusion： There is no significant role of adding on bone marrow aspirate instillation at the fracture site in cases of fresh fracture of intracapsular neck femur treated by head preserving surgery in terms of accelerating the bone healing and reducing the incidence of femoral head necrosis.