膀胱截石位手术单设计及应用价值研究

朱荣荣; 陈荣珠; 彭程; 王桂红; 王文姬; 蒋琴琴

doi:10.16766/j.cnki.issn.1674-4152.002567

膀胱截石位手术单设计及应用价值研究

doi: 10.16766/j.cnki.issn.1674-4152.002567

中国科学技术大学附属第一医院手术室，安徽合肥 230001

基金项目:

安徽省科学技术厅重点研究与开发计划项目 202004j07020016

详细信息

通讯作者:
陈荣珠, E-mail: rzchen508@139.com

中图分类号: R472.3 R713
计量
- 文章访问数: 270
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- PDF下载量: 3
- 被引次数: 0
出版历程
- 收稿日期: 2021-09-02
- 网络出版日期: 2022-09-23

Design of surgical drapes for bladder lithotomy position and its application value

Operating Room, the First Affiliated Hospital of USTC, Hefei, Anhui 230001, China

摘要

摘要: 目的设计膀胱截石位手术单, 以满足手术精准配合需求、节约医院成本支出和缩短铺巾时间。方法设计并制作出膀胱截石位手术单，并与传统手术单进行比较。选择2020年5—12月在中国科学技术大学附属第一医院妇科需要摆膀胱截石位的手术患者100例为研究对象，以随机数字表法分为对照组和观察组各50例，比较2组手术单在铺巾耗时、耗材成本支出、术中敷料移位次数及加铺时间、器械掉落次数。结果对比2组铺巾时间, 对照组铺巾总时间8 683 s, 术中加铺时间423 s, 共耗时9 106 s, 每例铺巾时间169.00(163.00，178.00) s；观察组铺巾总时间5 339 s, 术中无加铺，每例铺巾时间108.50(98.75，115.25) s；观察组所用的铺巾时间短于对照组(P＜0.001)。对比2组的术中加铺及器械掉落，对照组术中加铺11例，观察组术中加铺0例，观察组明显少于对照组，差异有统计学意义(P＜0.001)；对照组术中器械掉落5例，观察组术中器械掉落2例，观察组术中器械掉落次数较对照组少，但差异无统计学意义(P＞0.05)。结论膀胱截石位手术单一体化设计，整体平整美观，可操作性强，省时省力，成本低，节约医疗成本；专用器袋便于术中器械洁污分区管理，减少器械掉落，避免手术部位感染；Time out设计督促三方核查严格执行，保证患者安全，值得临床推广使用。
- 膀胱截石位 /
- 手术单 /
- 节约成本 /
- 术中优势
Abstract: Objective The surgical drapes for bladder lithotomy position are designed to meet the needs of precise operation support, save cost and reduce draping time. Methods A surgical drape for bladder lithotomy position was designed, created and compared with traditional surgical drapes. A total of 100 cases of patients requiring bladder lithotomy in the Department of Gynaecology, The First Affiliated Hospital of USTC from May 2020 to December 2020 were selected as the research objects. Fifty cases were randomly chosen as the control group and another 50 cases as the observation group. The two groups of surgical kits were compared in terms of time spent on the draping, cost of consumables used, number of shifts of the dressing during operation and time of added draping and number of tool drops in the two groups. Results The total laying time of the observation group was 5 339 s (no added draping required), shorter than that of the control group, which was 8 683 s (total of 9 106 s with additional 423 s for the added draping due to intraoperative overlays). The difference was statistically significant (P < 0.001). The number of intraoperative overlays in the observation group was 0, significantly less than that in the control group, which was 11, and the difference was statistically significant (P < 0.001). The number of tool drops in the observation group was only 2, less than 5 in the control group, with no statistical difference (P>0.05). Conclusion The proposed surgical drape design for bladder lithotomy position exhibits an integrated configuration with separate areas for clean and dirty tools during surgical operation. It is flat and beautiful in appearance, easy to operate, hassle free and cost saving. The special bagging design makes it possible to separate clean and dirty areas, thus reducing the chances of tool dropping and avoiding infection on surgery. In addition, the unique "time out" design enhances strict inspections from all three parties involved, which contributes to ensuring patient safety. Therefore, the proposed design is worthy of promotion and application.
- Bladder lithotomy position /
- Surgical drape /
- Cost saving /
- Intraoperative advantage

HTML全文

图 1 膀胱截石位手术单结构示意图

Figure 1. Schematic diagram of the structure of the surgical drape in the lithotomy position

下载: 全尺寸图片幻灯片

图 2 两处器械袋及使用图

注：A为妇科专用宫颈扩张棒器械袋；B为使用中的宫颈扩张棒器械袋；C为腔镜器械专用袋；D为使用中的腔镜器械专用袋。

Figure 2. Two instrument bags and usage diagrams

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图 3 Time out标志

Figure 3. Time out Sign

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图 4 膀胱截石位手术单整体效果图

Figure 4. The overall effect of the surgical drape in the bladder lithotomy position

下载: 全尺寸图片幻灯片

表 1 各布巾成本核算[元/包(次)]

Table 1. Cost accounting of each towel [CNY/bag (times)]

敷料名称	成品成本	折旧费	清洗费	人工费	消毒费	合计
治疗巾	15.00	0.30	0.50			0.80
中包布	40.00	0.80	1.00			1.80
中单	40.00	0.80	1.00			1.80
手术单	65.50	13.10	1.50			14.60
补充敷料	150.00	3.00	4.00	5.46	15.00+0.20+0.50	28.16
传统手术包	285.50	17.50	7.50	10.90	15.00+0.20+0.50	51.60
截石位手术包	303.10	18.90	9.50	10.90	15.00+0.20+0.50	54.70
注：折旧费以清洗50次计算。

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表 2 2组患者铺巾时间、术中加铺及器械掉落比较

Table 2. Comparison of drape time, intraoperative extra-laying and instrument drop between 2 groups of patients

组别	例数	铺巾时间[M(P₂₅, P₇₅), s]	术中加铺[敷料移位，例(%)]	器械掉落[例(%)]
观察组	50	108.50(98.75，115.25)	0	2(4.0)
对照组	50	169.00(163.00，178.00)	11(22.0)	5(10.0)
统计量		-8.614^a	12.360^b	0.614^b
P值		< 0.001	< 0.001	0.433
注：^a为Z值，^b为χ²值。

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