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目的探讨直肠癌根治术中安置截石位时两种下肢置放方法对患者循环、呼吸的影响。方法将于截石位下实施直肠癌根治手术的48例患者随机分为观察组和对照组各24例。观察组采取先抬高左下肢,1 m in后再抬高右下肢,手术后先平放左下肢,1 m in后再平放右下肢的体位置放方法;对照组手术前、后采取同时抬高、同时平放双下肢的体位置放方法。结果体位置放后1 m in、3 m in,对照组血压与置放前比较,差异有显著性意义(均P<0.05);观察组血压变化不明显(P>0.05);两组体位置放后1 m in、3 m in血压比较,差异有显著性意义(均P<0.05)。术毕体位恢复后1 m in、3 m in对照组血压与术毕体位恢复前比较,差异有显著性意义(均P<0.05),观察组血压变化不明显(P>0.05);两组体位恢复后1 m in、3 m in血压比较,差异有显著性意义(均P<0.05);两组体位置放前、后心率和血氧饱和度均无明显变化(均P>0.05)。结论对直肠癌根治术患者采用先后置放、恢复下肢体位的方法,可预防截石体位改变时发生严重的循环系统并发症。
Objective To investigate the effects of two lower extremity placement methods on circulation and respiration in patients undergoing radical resection of rectal cancer with lithotomy position. Methods Forty-eight patients undergoing radical resection of rectal cancer under the lithotomy position were randomly divided into observation group (24 cases) and control group (24 cases). In the observation group, the left lower extremity was lifted first, then the right lower extremity was elevated 1 m in. After the operation, the lower extremity was laid flatly, and the body position of the lower extremity was placed 1 m in. The control group was operated at the same time Elevated, at the same time lying on both legs of the body position method. Results There was significant difference in blood pressure between control group and control group (P <0.05). There was no significant difference in blood pressure between observation group and control group (P> 0.05) After 1 m in, 3 m in blood pressure, the difference was significant (P <0.05). The blood pressure in the control group after 1 m in, 3 m in the recovery of the operative position was significantly different from that before operation (P <0.05), but no significant changes in the blood pressure in the observation group (P> 0.05) After 1 m in, 3 m in blood pressure, the difference was significant (both P <0.05). There was no significant change in heart rate and blood oxygen saturation between the two groups (all P> 0.05). Conclusion The method of placing patients one after another and restoring the positions of the lower extremities in patients undergoing radical resection of the rectum can prevent serious circulatory complications when the position of the lithotomy is changed.