摘要: |
目的:探讨基于人体工程学的新型人字体位在输尿管软镜碎石手术中的应用效果以及对医护舒适度的影响。方法:于2023年6月至2023年12月从复旦大学附属中山医院总院、徐汇区中心医院、闵行区中心医院、复旦中山厦门医院通过目的选样选取24名泌尿外科医生及32名手术室护士进行前瞻性、多中心研究。并通用随机数字表法将研究对象分为传统截石位组和新型人字体位组,每组均包含4个中心的医生12名以及护士16名。采用主观心智负荷问卷(SMEQ)和局部体验不适量表(LED)对医护的心理和生理压力水平进行评价。其他研究参数包括护士体位摆放疲劳度以及不同体位对手术的影响。结果:问卷收回率100%,结果显示新型人字体位组医护LED评分较传统截石位组显著降低(P<0.01);新型人字体位组护士SMEQ评分、体位摆放疲劳度均优于传统截石位组(P<0.01);两组医生SMEQ评分及不同体位对脏器损伤风险的评定差异无统计学意义(P>0.05);两组医生评定新型人字体位组就体位对清石率、应急处理以及手术时间的影响明显优于传统截石位组(P<0.01);两组患者手术体位摆放时间差异无统计学意义(P>0.05),但新型人字体位组患者体位归位时间明显少于传统截石位组(P<0.01)。结论:以人体工程学理论为基础的新型人字体位对于手术医生、护士在身心压力方面明显优于传统截石位,具有较高的临床应用价值。 |
关键词: 输尿管软镜碎石术 新型人字体位 截石位 人体工程学 |
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Application of a new human font position in ureteral flexible lithotripsy surgery |
wang zhe, dong li
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Zhongshsan hospital Fudan University
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Abstract: |
Objective: To explore the effect of a new ergonomically based human font position in ureteral flexible lithotripsy and its impact on healthcare comfort. Methods: 24 urologists and 32 operating room nurses were selected through purposive sampling from June 2023 to December 2023 from the General Hospital of Zhongshan Hospital affiliated with Fudan University, Xuhui District Central Hospital, Minhang District Central Hospital, and Fudan Zhongshan Xiamen Hospital for a prospective, multicenter study. The study subjects were divided into the traditional lithotomy position group and the modified dorsal recumbent position group by the general random number table method, and each group contained 12 doctors and 16 nurses from 4 centers. The subjective mental load questionnaire (SMEQ) and localized experienced discomfort scale (LED) were used to evaluate the psychological and physiological stress levels of the healthcare workers. Other parameters studied included nurses' position placement fatigue and the effect of different positions on surgery.Results: The return rate of the questionnaire was 100%, and the results showed that the LED scores of healthcare nurses in the modified dorsal recumbent position group were significantly lower than those in the traditional lithotomy position group (P<0.01); the SMEQ scores of nurses in the modified dorsal recumbent position group and the fatigue level of postural placement were better than those in the traditional lithotomy position group (P<0.01); the differences in SMEQ scores of the doctors in the two groups and the assessment of the risk of organ damage by different postures were statistically insignificant (P>0.05); doctors of the two groups rated that the modified dorsal recumbent position group was significantly better than the traditional lithotomy position group with regard to the effect of the position on the stone clearance rate, emergency treatment, and operation time (P<0.01).There was no statistically significant difference in the surgical position placement time between the two groups (P>0.05), but the position return time of patients in the modified dorsal recumbent position group was significantly less than that in the traditional lithotomy position group (P < 0.01). Conclusion: The modified dorsal recumbent position based on ergonomic theory is significantly better than the traditional lithotomy position for surgeons and nurses in terms of physical and mental stress, and has high clinical application value. |
Key words: ureteral flexible lithotripsy modified dorsal recumbent position (MDRP) lithotomy position (LP) ergonomics |