摘要
目的分析甲状腺手术体位摆放的最佳时机及其对患者术后不适症的影响。方法采用前瞻性研究的方法,将2016年1月至2017年10月上海东方肝胆外科医院收治的100例行甲状腺手术治疗的患者,采用随机数字表法分为观察组和对照组,每组各50例,观察组手术体位摆放在麻醉诱导前完成,对照组则在麻醉插管后完成。比较两组患者手术体位维持时间、手术时间、麻醉插管时间,以及颈、肩、腰部疼痛度、咽部疼痛视觉模拟评分(VAS)、咽部不适发生率、恶心呕吐发生级别。结果观察组手术体位维持时间、手术时间、麻醉插管时间与对照组比较,差异均无统计学意义(P>0.05);观察组颈、肩、腰部Ⅲ+Ⅳ度疼痛率(6.00%)较对照组(20.00%)低;术后咽部VAS较对照组低,咽部不适发生率(26.00%)较对照组(56.00%)低,差异均具有统计学意义(P<0.05);观察组Ⅲ+Ⅳ级恶心呕吐发生率(6.00%)较对照组(20.00%)低,观察组患者满意率(92.00%)明显高于对照组(76.00%),差异均具有统计学意义(P<0.05)。结论不同手术体位摆放时间对甲状腺手术患者术后不适症状有所影响,在麻醉诱导前完成手术体位摆放能缓解术后患者颈肩和腰部疼痛、咽部不适感,缓解恶心呕吐症状,提高患者满意率。
Objective To analyze the best time for position of thyroid surgery and its influence on patients with postoperative discomfort.Methods The clinical data of 100 patients underwent surgical treatment of thyroid according to different position in this hospital during January 2016 to October 2017 were retrospectively reviewed and analyzed. They were divided into observation group and control group by using random number table method,50 cases in each group. The position of operation in patients of observation group was complete before anesthesia induction,the position of operation in patients of control group was completed after intubation of anesthesia. Compare two groups of patients with The maintain time for surgical position,operating time,anesthesia intubation time and visual analogue scale（ VAS） scores of the degree of neck,shouldeer,waist and pharyngeal pain,and the incidence of pharyngeal discomfort,nausea and vomiting. Results The duration for maintainence of operating position,operating time,anesthesia intubation time in observation group were compared with those of control group,there was no statistically significant difference（ P〈0. 05）. The rate of III ＋ IV degree of neck,shoulder,waist pain（ 6. 00%） in observation group was lower than that（ 20. 00%） of control group.Postoperative pharyngeal VAS scores were lower than those of control group,the incidence of pharyngeal discomfort（ 26. 00%） was lower than that（ 56. 00%） of control group,and the difference was statistically significant（ P〈0. 05）. The incidence of nausea and vomiting（ 6. 00%） was lower than that（ 20. 00%） of control group,and the difference was statistically significant（ P〈0. 05）. Conclusion Different mainteaining time of surgial position may influence postoperative symptoms in patients with thyroid surgery,and the position before anesthesia induction can alleviate postoperative neck,shoulder and waist pain,pharyngeal discomfort,alleviate symptoms of nausea and vomiting,and improve the satisfaction of patients.
作者
徐大鹏
张津玮
马优刚
XU Da - peng;ZHANG fin - wei;MA You - gang.(Department of General Surgery, Shanghai Oriental Courage Surgical Hospital, Shanghai 201805, China.)
出处
《临床和实验医学杂志》
2018年第11期1228-1231,共4页
Journal of Clinical and Experimental Medicine
关键词
甲状腺手术
手术体位
时机
麻醉诱导
术后不适症
Thyroid surgery
Operating position
Time
Anesthesia induction
Discomfort after operation
