股骨粗隆间骨折内固定术麻醉前与麻醉后摆放体位对健侧髋关节的影响对比分析
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摘要
目的:探讨粗隆间骨折内固定术麻醉前与麻醉后摆放体位对健侧髋关节的影响。方法:分析2015年12月-2017年12月于我院住院并行手术的76例粗隆间骨折患者,其中行股骨近端防旋髓内钉(PFNA)术患者42例,行(DHS)术患者34例,76例患者所采用的手术体位均为半截石位。按照随机原则将76例患者分为对照组和试验组,对照组包括行PFNA术患者21例,行DHS术患者16例,试验组包括行PFNA术患者21例,行DHS术患者18例。对照组患者先采用气管插管,待全麻完成后,由医护人员行半截石位摆放,试验组在患者清醒状态下,主动配合医护人员行半截石位摆放。比较两组手术患者术后健侧髋关节的状况,是否伴有局部皮肤压伤、麻木、疼痛及活动受限。结果:以术后患者健侧髋关节部是否出现局部皮肤压伤、麻木、疼痛及活动受限为观察依据,对照组中患者术后出现健侧髋部不适者8例,试验组中患者术后出现健侧髋部不适者1例,与对照组患者相比,麻醉前摆放体位较麻醉后摆放体位者有更高的舒适度,有效避免了健侧髋关节的局部皮肤压伤、麻木、疼痛及活动受限,且麻醉前摆放体位耗时更短,其所需配合的医护人员更少,差异有统计学意义(P<0.05)。结论:股骨粗隆间骨折内固定术中麻醉前摆放体位较麻醉后摆放体位对健侧髋关节影响更小,舒适度更高,能有效地提高手术操作效率和节约医护力量。
Objective: To investigate the effect of fixation of intertrochanteric fracture on the body position before anesthesia and after anesthesia on healthy hip; Methods: 76 cases of surgically treated intertrochanteric fractures treated from December 2015 to December 2017 in our hospital was analyzed, including Proximal Femoral Nail Antirotation(PFNA) in 42 patients with action, Dynamic Hip Screw(DHS) in 34 cases of patients, 76 cases of surgical position applied half lithotomy position. According to the random principle, 76 patients were divided into the control group and the experimental group. The control group included 21 patients undergoing PFNA operation and 16 patients undergoing DHS operation. The experimental group included 21 patients undergoing PFNA operation and 18 patients undergoing DHS. Patients in the control group received tracheal intubation. After the completion of general anesthesia, they were placed in half stone position by medical staff. The patients in the experimental group received the half stone position with the doctors and nurses when they were awake. Results: With local skin crush, numbness, pain and limitation of activity of the healthy hip as the objective basis in postoperative patients, 8 patients suffered from healthy hip discomfort in the control group and 1 case suffered from healthy hip discomfort after surgery in the experimental group, compared with the control group, the position placed before anesthesia had higher comfort than body position placed after anesthesia, and it could effectively avoid the local skin bruise of the healthy hip, numbness, pain and dysfunction, and body position placed before anesthesia consumed less time, the need to cooperate with the medical staff was less, the difference was statistically significant(P<0.05); Conclusion: Fixation of body position for intertrochanteric fracture before anesthesia had less effect on the healthy hip than body position after anesthesia, it was more comfortable, and could effectively improve the operation efficiency and save the medical resources.
Objective: To investigate the effect of fixation of intertrochanteric fracture on the body position before anesthesia and after anesthesia on healthy hip; Methods: 76 cases of surgically treated intertrochanteric fractures treated from December 2015 to December 2017 in our hospital was analyzed, including Proximal Femoral Nail Antirotation(PFNA) in 42 patients with action, Dynamic Hip Screw(DHS) in 34 cases of patients, 76 cases of surgical position applied half lithotomy position. According to the random principle, 76 patients were divided into the control group and the experimental group. The control group included 21 patients undergoing PFNA operation and 16 patients undergoing DHS operation. The experimental group included 21 patients undergoing PFNA operation and 18 patients undergoing DHS. Patients in the control group received tracheal intubation. After the completion of general anesthesia, they were placed in half stone position by medical staff. The patients in the experimental group received the half stone position with the doctors and nurses when they were awake. Results: With local skin crush, numbness, pain and limitation of activity of the healthy hip as the objective basis in postoperative patients, 8 patients suffered from healthy hip discomfort in the control group and 1 case suffered from healthy hip discomfort after surgery in the experimental group, compared with the control group, the position placed before anesthesia had higher comfort than body position placed after anesthesia, and it could effectively avoid the local skin bruise of the healthy hip, numbness, pain and dysfunction, and body position placed before anesthesia consumed less time, the need to cooperate with the medical staff was less, the difference was statistically significant(P<0.05); Conclusion: Fixation of body position for intertrochanteric fracture before anesthesia had less effect on the healthy hip than body position after anesthesia, it was more comfortable, and could effectively improve the operation efficiency and save the medical resources.
引文
[1]蔡东岭,曾巧,陈晓峰,等.不同手术体位应用股骨近端锁定板治疗老年股骨粗隆间骨折的疗效分析[J].西部医学,2013,25(8):1155-1159.
[2]方晓玲.全麻前后安置截石位对患者舒适度的影响[J].临床护理杂志.2009,8(5):28-29.
[3]冯彩云.全麻前后截石位的摆放对病人下肢的影响[J].医学理论与实践2011,24(8):972-973.
[4]张秀华,林建玲,朱琳,等.手术患者截石位摆放时机的护理研究[J].护理研究,2013,10(2):149-153.
[5]刘宪昌.体位对股骨近端防旋髓内钉(PFNA)内固定治疗不稳定股骨粗隆间骨折疗效的影响[J].创伤外科杂志,2016,18(10):620-621.
[6]顾岗花.在麻醉前与麻醉后为妇科手术患者取截石体位的效果对比[J].当代医药论丛,2017,15(16):236-238.
[2]方晓玲.全麻前后安置截石位对患者舒适度的影响[J].临床护理杂志.2009,8(5):28-29.
[3]冯彩云.全麻前后截石位的摆放对病人下肢的影响[J].医学理论与实践2011,24(8):972-973.
[4]张秀华,林建玲,朱琳,等.手术患者截石位摆放时机的护理研究[J].护理研究,2013,10(2):149-153.
[5]刘宪昌.体位对股骨近端防旋髓内钉(PFNA)内固定治疗不稳定股骨粗隆间骨折疗效的影响[J].创伤外科杂志,2016,18(10):620-621.
[6]顾岗花.在麻醉前与麻醉后为妇科手术患者取截石体位的效果对比[J].当代医药论丛,2017,15(16):236-238.