CAJ | 학술논문

目的：探讨不同体位在经肛门内镜微创治疗局限性直肠肿瘤的手术配合护理方法。方法将120例直肠肿瘤患者按数字随机法分为观察组和对照组，每组患者各60例。观察组术前抬高左下肢1 min后再抬高右下肢，术后亦平放左下肢1 min后再平放右下肢。对照组术前和术后均后同时抬高和平放双下肢。两组患者均采取常规护理，比较患者术后疼痛、患者满意度和血流动力学。结果观察组疼痛评分得分在5分以下的患者比例高于对照组，疼痛评分得分在5分以上的患者比例则低于对照组，差异有统计学意义（P＜0.01）。观察组患者满意度为80.00％，显著高于对照组（56.67％，χ2＝6.87，P＜0.01）。术后观察组患者的收缩压（SBP）、舒张压（DBP）、平均动脉压（MAP）、心率（HR）、中心静脉压（CVP）等血流动力学水平控制均优于对照组（P＜0.05）。结论采用单侧下肢截石位配合护理可更有效地减轻局限性直肠肿瘤患者经肛门内镜微创手术疼痛，提高患者满意度和控制血流动力学水平，值得临床推广使用。
목적：탐토불동체위재경항문내경미창치료국한성직장종류적수술배합호리방법。방법장120례직장종류환자안수자수궤법분위관찰조화대조조，매조환자각60례。관찰조술전태고좌하지1 min후재태고우하지，술후역평방좌하지1 min후재평방우하지。대조조술전화술후균후동시태고화평방쌍하지。량조환자균채취상규호리，비교환자술후동통、환자만의도화혈류동역학。결과관찰조동통평분득분재5분이하적환자비례고우대조조，동통평분득분재5분이상적환자비례칙저우대조조，차이유통계학의의（P＜0.01）。관찰조환자만의도위80.00％，현저고우대조조（56.67％，χ2＝6.87，P＜0.01）。술후관찰조환자적수축압（SBP）、서장압（DBP）、평균동맥압（MAP）、심솔（HR）、중심정맥압（CVP）등혈류동역학수평공제균우우대조조（P＜0.05）。결론채용단측하지절석위배합호리가경유효지감경국한성직장종류환자경항문내경미창수술동통，제고환자만의도화공제혈류동역학수평，치득림상추엄사용。
Objective To explore the different postures nursing effect in anal endoscopic minimally invasive treatment on localized colorectal cancer.Methods 120 patients with rectal cancer were divided into the observation group and the control group by digital randomized method.Each group included 60 cases.For observation group , the left leg was pushed up and 1 min later the right leg was pushed up.After surgery , left leg was lowered down and 1 min later the right leg was lowered down.For control group , two legs were pushed up and lowered down at the same preoperative and postoperative time.Regular nursing was taken for patients in two groups.Postoperative pain , patient satisfaction and hemodynamics of the two groups were compared.Results Rate of patients in observation group with pain score below 5 points was higher than that of control group , and rate of patients with score more than five points was lower than the control group.The difference was statistically significant (P<0.01).Satisfaction rate of observation group was 80%, which was significantly higher than that of control group (56.67%,χ2 =6.87, P<0.01).Control of SBP, DBP, MAP, CVP and HR hemodynamic level of observation group was superior to that of control group ( P<0.05 ).Conclusion Nursing with single leg lithotomy position can effectively reduce surgical pain of rectal cancer patients treated with anal endoscopic minimally invasive surgery , improve patient satisfaction and control hemodynamics.It is worthy of promotion.