中西医结合护理 (Jan 2024)
Application of modified hemilithotomy position in the proximal femoral nail anti-rotation internal fixation (改良单腿截石位牵引体位在股骨近端抗旋转髓内钉内固定手术中的应用)
Abstract
Objective To evaluate the modified hemilithotomy position in the proximal femoral nail anti-rotation internal fixation. Methods Totally 55 patients undergoing proximal femoral nail anti-rotation (PFNA)internal fixation under intraspinal anesthesia were randomly divided into the observation(n=28) group and control group(n=27). Patients in the control group were placed in a routine supine position on the traction table, and those in the observation group were placed in the modified hemilithotomy position on the traction table. The surgical time, X-ray imaging time, degree of comfort with positioning and positioning-related complications were observed and compared between two groups. Results The surgical time and X-ray imaging time in the observation group were shorter than those in the control group, with a significant difference (P＜0. 01). The score of Operation Position Comfort Questionnaire in the observation group was higher than that in the control group(68. 11±11. 35 vs. 56. 85±11. 01, P＜0. 01). The incidence of positioning-related complications in the observation group was lower than that in the control group, with a significant difference(P＜0. 05). Conclusion The modified hemilithotomy position with traction technique is a physiological positioning which could improve comfort degree of patient undergoing proximal femoral nail anti-rotation internal fixation, reduce the risk of positioning-related complications, shorten the X-ray imaging time and ensure the success of the surgery. (目的 探讨改良单腿截石位牵引体位在股骨近端抗旋转髓内钉内固定手术中的应用效果。方法 选取2020年10月—2022年8月在医院手术室实施椎管内麻醉下股骨近端抗旋转髓内钉内固定手术的55例患者作为研究对象, 采用随机数字表法分为观察组(n=28)和对照组(n=27)。对照组采用仰卧位结合牵引床的常规牵引位, 观察组采用单腿截石位结合牵引床的改良牵引位。比较两组患者的手术时间、透视时间、术中体位舒适程度以及术后体位相关并发症的发生率。结果 观察组的手术时间、透视时间均短于对照组, 差异有统计学意义(P＜0. 01); 观察组手术体位舒适性量表(OPCQ)评分(68. 11±11. 35)分, 高于对照组的(56. 85±11. 01)分, 差异有统计学意义(P＜0. 01); 观察组术后体位相关并发症的发生率低于对照组, 差异有统计学意义(P＜0. 05)。结论 对于股骨近端抗旋转髓内钉内固定手术患者而言, 采用单腿截石位结合牵引床的改良手术体位更符合其生理特点, 增加体位舒适度, 减少术后体位相关并发症的发生风险, 缩短无效手术时间和透视时间, 确保手术的顺利进行。)
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