中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (30): 5679-5683.doi: 10.3969/j.issn.1673-8225.2011.30.041

• 骨与关节临床实践 clinical practice of the bone and joint • 上一篇    下一篇

经皮椎体成形手术体位对患者生命体征和血氧饱和度的影响

林学扬1，张  亮1，高梁斌2，张  志1，尹  飚1   

  1. 1广州医学院第三附属医院脊柱外科，广东省广州市  510150
    2中山大学附属孙逸仙纪念医院骨外科，广东省广州市510150
  • 收稿日期:2011-01-17 修回日期:2011-04-15 出版日期:2011-07-23 发布日期:2011-07-23
  • 通讯作者: 张亮，副主任医师，广州医学院第三附属医院脊柱外科，广东省广州市510150 zldxx861@sina.com
  • 作者简介:林学扬★，男，1982年生，广东省潮安县人，汉族，广州医学院在读硕士，医师，主要从事脊柱骨科及创伤骨科专业研究。 whhlxy@qq.com
  • 基金资助:

    广州市医药卫生科技项目(2009-YB-165)。

Effects of body position on vital signs and blood oxygen saturation of patients during percutaneous vertebroplasty

Lin Xue-yang1, Zhang Liang1, Gao Liang-bin2, Zhang Zhi1, Yin Biao1   

  1. 1Department of Spinal Surgery, Third Affiliated Hospital of Guangzou Medical College, Guangzhou  510150, Guangdong Province, China
    2Department of Bone Surgery,  Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou  510150, Guangdong Province, China
  • Received:2011-01-17 Revised:2011-04-15 Online:2011-07-23 Published:2011-07-23
  • Contact: Zhang Liang, Associate chief physician, Department of Spinal Surgery, Third Affiliated Hospital of Guangzou Medical College, Guangzhou 510150, Guangdong Province, China zldxx861@sina.com
  • About author:Lin Xue-yang★, Studying for master’s degree, Physician, Department of Spinal Surgery, Third Affiliated Hospital of Guangzou Medical College, Guangzhou 510150, Guangdong Province, China whhlxy@qq.com
  • Supported by:

    Medical and Health Technology Program of Guangzhou City, No. 2009-YB-165*

PDF

313

被引次数

17

摘要：

背景：尽管有学者肯定了侧卧位行经皮椎体成形的效果及安全性，但对于手术体位在术中对生命体征影响变化尚未见报道。
目的：观察经皮椎体成形手术中不同体位对患者生命体征和血氧饱和度的影响。
方法：将30例胸腰椎骨质疏松性压缩骨折患者随机分组为2组，分别以俯卧位和侧卧位行经皮椎体成形手术。观察并记录患者在术前仰卧位(T1)、转变手术体位后5 min(T2)、穿刺进针过程(T3)、注射骨水泥过程(T4)、骨水泥注射结束(T5)和术后仰卧5 min(T6)生命体征和血氧饱和度的变化。
结果与结论：俯卧位组T1、T2、T3、T4、T5时间点心率、呼吸频率均高于侧卧位组(P < 0.05)。俯卧位组T2、T3时间点收缩压高于侧卧位组(P < 0.05)。俯卧位组T5时间点血氧饱和度低于侧卧组(P < 0.05)。说明行经皮穿刺椎体成形手术时采用侧卧位较俯卧位对患者生命体征和血氧饱和度的影响小，且侧卧位有利于提高患者手术耐受性。

关键词: 经皮椎体成形术, 骨水泥, 体位, 生命体征, 血氧饱和度

Abstract:

BACKGROUND: Although some scholars have affirmed the effect and safety of lateral position for percutaneous vertebroplasty. But impact of surgical position on the changes in the vital signs during the operation has not been reported.
OBJECTIVE: To observe the effects of different body position in vital signs and blood oxygen saturation of patients during percutaneous vertebroplasty.
METHODS: Thirty cases of thoracolumbar osteoporotic vertebral compression fractures (OVCF) were divided into two groups randomly: the prone position group (15 cases) and the lateral position group (15 cases), both of them are given local anesthesia for percutaneous vertebroplasty. Record of vital signs and blood oxygen saturation for each patient in the following time points were observed, including supine position before surgery (T1), 5 minutes after body position changing (T2), the process of needle puncturing (T3), the process of injection of bone cement (T4), at the end of bone cement injection (T5), the supine position after surgery for 5 minutes (T6).
RESULTS AND CONCLUSION: In the prone position group, the heart rate and respiratory rate were higher than those of the lateral position group (P < 0.05) in the time points including T1, T2, T3, T4, T5. The artery systolic pressure in the prone position group was lower than that of the lateral position group (P < 0.05) in the time points including T2, T3. The blood oxygen saturation in the prone position patients group was lower than that of the lateral group (P < 0.05) in the T5 time point. The above shows that the lateral position has less effect on the patient’s vital signs and oxygen saturation than the prone position, which is also conducive to improve the tolerance operation of patients during the percutaneous vertebroplasty. 

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