麻醉前后不同时机截石位摆放对全麻手术患者舒适度及摆放时间的影响

徐英豪; 王磊; 张叶贤; 程熠; 王艳

doi:10.16766/j.cnki.issn.1674-4152.003486

麻醉前后不同时机截石位摆放对全麻手术患者舒适度及摆放时间的影响

doi: 10.16766/j.cnki.issn.1674-4152.003486

徐英豪¹,
王磊^2, ,,
张叶贤¹,
程熠²,
王艳¹

1.
平湖市第一人民医院手术室，浙江平湖 314200
2.
平湖市第一人民医院麻醉科

基金项目:

浙江省医药卫生科技计划项目 2020PY078

详细信息

通讯作者:
王磊，E-mail：13615739338@163.com

中图分类号: R472.3 R614.2
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- 文章访问数: 49
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- 被引次数: 0
出版历程
- 收稿日期: 2023-10-09
- 网络出版日期: 2024-05-29

The effect of lithotomy positions placement at different times before and after anesthesia on the comfort and placement time of patients undergoing general anesthesia surgery

1.
Operating Room, Pinghu First People ' s Hospital, Pinghu, Zhejiang 314200, China

摘要

摘要: 目的分析麻醉前后不同时机进行截石位摆放在全麻手术患者中的应用效果，分析其对患者术前焦虑、舒适度、压力性损伤情况及摆放时间的影响。方法选取2022年1月—2023年8月在平湖市第一人民医院手术室需在截石位下行全麻手术的210例患者作为研究对象，采用随机数字表法将其分为对照组(105例)和观察组(105例)。对照组患者在全身麻醉诱导插管后进行截石位摆放，观察组患者于麻醉前进行体位宣教及摆放，比较2组患者体位摆放时间及舒适度评分，对比2组患者术前焦虑情况及压力性损伤情况。结果观察组患者体位摆放时间为(6.46±1.75)min，短于对照组的(10.14±2.28)min，观察组舒适度得分为(70.24±6.33)分，高于对照组的(59.55±7.47)分，差异均有统计学意义(P < 0.05)。干预后，观察组患者阿姆斯特丹术前焦虑与信息量表(APAIS)各维度得分均明显低于对照组(P < 0.05)。观察组患者压力性损伤发生率为3.8%(4/105)，低于对照组的11.4%(12/105)，差异有统计学意义(P < 0.05)。结论全麻手术患者于麻醉前进行截石位体位宣教及摆放能缩短体位摆放时间，减轻患者术前焦虑情况，提高患者舒适度，减少压力性损伤发生率。
- 全麻手术 /
- 截石位 /
- 体位摆放 /
- 舒适度 /
- 术前焦虑 /
- 压力性损伤
Abstract: Objective Analyze the application effect of lithotomy positions at different times before and after anesthesia in patients undergoing general anesthesia surgery, and analyze their impact on preoperative anxiety, comfort, pressure injury, and placement time. Methods A total of 210 patients who underwent general anesthesia surgery at the lithotomy position in the operating room of the Pinghu First People ' s Hospital from January 2022 to August 2023 were selected as the study subjects. They were equally divided into a control group and an observation group using a random number table method. The control group patients were placed in the lithotomy position after induction of general anesthesia and intubation, while the observation group patients received posture education and placement before anesthesia. The position placement time, comfort scores, preoperative anxiety, and stress injury of patients in the two groups were compared. Results The positioning time of the observation group patients was (6.46±1.75) min, which was shorter than the control group [(10.14±2.28) min]. The comfort score of the observation group was 70.24±6.33, which was higher than the control group (59.55±7.47), with a statistically significant difference (P < 0.05). After intervention, the Amsterdam preoperative anxiety information scale (APAIS) was significantly lower than that of the control group, with statistically significant differences (P < 0.05). The incidence of pressure injury in the observation group was 3.8% (4/105), significantly lower than the 11.4% (12/105) in the control group (P < 0.05). Conclusion Conducting lithotomy position education and placement before general anesthesia surgery can shorten the time for position placement, reduce preoperative anxiety, improve patient comfort, and reduce the incidence of stress injury.
- General anesthesia surgery /
- Lithotomy position /
- Positioning /
- Comfort level /
- Preoperative anxiety /
- Pressure injury

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表 1 2组手术患者一般情况比较

Table 1. Comparison of general information between two groups of surgical patients

项目	对照组(n=105)	观察组(n=105)	统计量	P值
性别(例)
男性	32	35	0.197^a	0.657
女性	73	70
年龄(x±s，岁)	44.17±6.86	44.33±5.39	0.188^b	0.851
手术时长(x±s，h)	1.32±0.21	1.27±0.30	1.399^b	0.163
术中失血量(x±s，mL)	372.41±22.56	372.26±25.71	0.045^b	0.964
术中低体温(例)
有	22	27	0.665^a	0.415
无	83	78
手术类型(例)
妇产科	64	63	0.146^a	0.930
普外科	16	18
泌尿外科	25	24
BMI(x±s)	22.88±4.63	22.94±4.12	0.099^b	0.921
慢性病史(例)
有	36	31	0.548^a	0.459
无	69	74
注：^a为χ²值，^b为t值。

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表 2 2组手术患者体位摆放时间及舒适度比较(x±s)

Table 2. Comparison of positioning time and comfort between two groups of surgical patients(x±s)

组别	例数	体位摆放时间(min)	舒适度(分)
对照组	105	10.14±2.28	59.55±7.47
观察组	105	6.46±1.75	70.24±6.33
t值		13.120	10.967
P值		< 0.001	< 0.001

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表 3 2组手术患者干预前后APAIS评分比较(x±s，分)

Table 3. Comparison of APAIS scores between two groups of surgical patients before and after intervention(x±s, points)

组别	例数	麻醉相关焦虑		手术相关焦虑		总体焦虑水平		信息需求
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
对照组	105	4.22±1.26	6.71±2.10	4.83±1.49	7.55±2.26	10.14±2.75	15.86±4.13	6.75±1.27	6.66±1.54
观察组	105	4.27±1.18	5.03±1.34	4.90±1.38	5.18±1.33	10.22±3.11	11.26±3.29	6.83±1.18	5.40±1.36
统计量		0.297^a	5.633^b	0.353^a	11.747^b	0.197^a	7.504^b	0.473^a	5.264^b
P值		0.767	< 0.001	0.724	< 0.001	0.844	< 0.001	0.637	< 0.001
注：^a为t值，^b为F值。

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表 4 2组手术患者压力性损伤发生情况比较[例(%)]

Table 4. Comparison of occurrence of pressure injury between two groups of surgical patients[cases(%)]

组别	例数	骶尾部	坐骨	支腿架接触部位	肩胛部	总发生
对照组	105	5(4.8)	3(2.9)	3(2.9)	1(1.0)	12(11.4)
观察组	105	2(1.8)	1(1.0)	1(1.0)	0	4(3.8)
注：2组压力性损伤总发生率比较，χ²=4.330，P=0.037。

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