一种布艺袖套式手托在侧卧位手术体位中的设计与应用
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摘要
目的介绍一种自行设计的布艺袖套式手托在侧卧位上臂摆放中的应用方法选择我院胸外科、泌尿外科需要侧卧位手术的患者98例,随机分为两组(对照组48例和实验组50例组),对照组采用传统标准的体位摆放方法放置上臂,实验组用自行设计的布艺袖套式手托放置上臂,分别统计两组患者的手臂酸痛麻木及皮肤压红现象。结果经比较发现,手术时间<3 h时,对照组与实验组手臂麻木酸痛及皮肤压红例数无显著差异(P>0.05);手术时间>3 h时,对照组患者手臂麻木酸痛及皮肤压红发生例数明显多于实验组(P<0.05)。结论采用这种自行设计的布艺袖套式手托在侧卧位体位摆放放置上臂可有效预防因体位摆放引起的相关并发症,提高患者手术舒适性,符合舒适化护理精神;而且能有效地暴露手术视野,提高术者操作空间;运用配件较少,降低医务人员工作强度。值得推广使用。
Objective To introduce the application of a self-designed fabric sleeve-type hand holder in the upper arm placement of the lateral position. Methods A total of 98 patients requiring lateral resection in Departments of Thoracic Surgery and Srinary Surgery of our hospital were selected and randomly divided into two groups(48 cases in the control group and 50 cases in the experimental group). The control group placed the upper arm with traditional standard position placement method, and the experimental group placed the upper arm with the self-designed fabric sleeve-type hand holder. The phenomenons of pain and numbness of the arms, and skin redness in the two groups were recorded separately. Results It was found that there was no significant difference in the number of cases with arm numbness and skin redness between the control group and the experimental group when the operation time was<3 h(P>0.05). When the operation time >3 h, the number of cases with arm numbness and skin redness in the control group was significantly higher than that in the experimental group(P<0.05). Conclusion The upper arm placement using the self-designed fabric sleeve-type hand holder in the lateral position can effectively prevent the related complications caused by the position placement, and improve the patients' comfort, which conforms to the comfortable nursing spirit. It can effectively expose the visual field of operation and improve the operator's operating space. It uses fewer accessories, which can reduce the working intensity of medical staff. Therefore, it is worthy of promotion.
Objective To introduce the application of a self-designed fabric sleeve-type hand holder in the upper arm placement of the lateral position. Methods A total of 98 patients requiring lateral resection in Departments of Thoracic Surgery and Srinary Surgery of our hospital were selected and randomly divided into two groups(48 cases in the control group and 50 cases in the experimental group). The control group placed the upper arm with traditional standard position placement method, and the experimental group placed the upper arm with the self-designed fabric sleeve-type hand holder. The phenomenons of pain and numbness of the arms, and skin redness in the two groups were recorded separately. Results It was found that there was no significant difference in the number of cases with arm numbness and skin redness between the control group and the experimental group when the operation time was<3 h(P>0.05). When the operation time >3 h, the number of cases with arm numbness and skin redness in the control group was significantly higher than that in the experimental group(P<0.05). Conclusion The upper arm placement using the self-designed fabric sleeve-type hand holder in the lateral position can effectively prevent the related complications caused by the position placement, and improve the patients' comfort, which conforms to the comfortable nursing spirit. It can effectively expose the visual field of operation and improve the operator's operating space. It uses fewer accessories, which can reduce the working intensity of medical staff. Therefore, it is worthy of promotion.
引文
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[12]兰惠华,杨秋香,杨雪玲,等.改良体位摆放在胸腔镜下行胸腺瘤切除术中的效果观察[J].基层医学论坛,2018,22(2):152-153.
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[15]陈杰霞,王莉,林穗红.改良侧卧位在胸腔镜手术中的应用[J].临床医学工程,2011,18(1):129-130.
[16]陈玉苹,康亚婵,林羡枝.舒适理论在手术侧卧位上肢安置改进中的应用[J].当代护士(下旬刊),2012,(5):90-91.
[17]丁玉辉,曾维君,杨晓莹.一次性固定带在胸科侧卧位体位安置中的应用观察[J].西南医科大学学报,2018,41(2):190-192.
[18]陈翠萍,杨英,余雷,等.改良侧卧位在胃食管结合部肿瘤手术中的应用[J].护理学杂志,2016,31(24):51-53.
[19]王珏,魏瑕,唐万彪.全身麻醉患者侧卧手术体位改进临床分析[J].现代医药,2010,26(12):1865-1866.
[2]姚月华.90°侧卧位手术患者体位并发症的预防与护理[J].现代医院,2008,8(11):80.
[3]柴艳红,贾丽娟,张红梅,等.侧卧位手术体位摆放研究进展[J].护理研究,2014,28(9):3336-3338.
[4]Schoonhoven L,Ddfloor T,Gryrpdonk MH.Incidence of pressure ulcers due to surgery[J].J Clin Nuts,2002,11(4):479-487.
[5]李丽,张丽,王惠琴.改良式手术侧卧位安置方法的应用[J].解放军护理杂志,2011,28(21):72-74.
[6]杨丹,杨波,王春梅.手术患者侧卧位上肢约束袋的制作与应用[J].护理学报,2013,(13):28.
[7]谢园园,郑丽萍,黄惠桥,等.改进型侧卧位托手架在胸部手术中的应用效果观察[J].护理实践与研究,2016,13(12):102-103.
[8]郑佳林,温霞,陈文局.改良侧卧位托手架在胸科手术中的应用[J].哈尔滨医药,2017,37(6):569-570.
[9]陈挺晖,吴秀红,魏永婷,等.三种侧卧位摆放方法在胸科手术中的应用效果观察[J].中国护理管理,2015,15(11):1338-1340.
[10]陈云超,唐晓娟.手术中压疮高危因素分析及防护进展[J].护士进修杂志,2013,25(15):1358-1359.
[11]中华护理学会手术室专业委员会.手术室护理实践指南(2018年版)[M].北京:人民卫生出版社,2018:53-55.
[12]兰惠华,杨秋香,杨雪玲,等.改良体位摆放在胸腔镜下行胸腺瘤切除术中的效果观察[J].基层医学论坛,2018,22(2):152-153.
[13]Gillespie R,Shishani Y,Streit J,et al.The safety of controlledhypotension for shoulder arthroscopy in the beach-chair position[J].J Bone Joint Surg Am,2012,94(14):1284-1290.
[14]Rains DD,Rooke GA,Wahl CJ.Pathomechanisms and complications related to patient positioning and anesthesia during shoulder-arthroscopy[J].Arthroscopy,2011,27(4):532-541.
[15]陈杰霞,王莉,林穗红.改良侧卧位在胸腔镜手术中的应用[J].临床医学工程,2011,18(1):129-130.
[16]陈玉苹,康亚婵,林羡枝.舒适理论在手术侧卧位上肢安置改进中的应用[J].当代护士(下旬刊),2012,(5):90-91.
[17]丁玉辉,曾维君,杨晓莹.一次性固定带在胸科侧卧位体位安置中的应用观察[J].西南医科大学学报,2018,41(2):190-192.
[18]陈翠萍,杨英,余雷,等.改良侧卧位在胃食管结合部肿瘤手术中的应用[J].护理学杂志,2016,31(24):51-53.
[19]王珏,魏瑕,唐万彪.全身麻醉患者侧卧手术体位改进临床分析[J].现代医药,2010,26(12):1865-1866.