手術中の頭低位における創傷や障害予防のための体位固定法評価

摘要

For robot-assisted surgery and endoscopic surgery, proper posture fixing and body pressure dispersion are required in trendelenburg position. However, the selection of the postural fixation method has been judged at each clinical site, and it is currently not quantitatively evaluated. In this study, strain state at the back part and movement amount of each part of the body were measured in the 2 kinds of body fixation methods under the condition of maintaining for 2 minutes in 30° trendelenburg position by the skin strain measurement method using strain gauge and motion analysis. As a result, it was shown that the strain in the sacrum is the largest in both fixation methods, that the movement of the body is reduced by the head and neck protector. Through these, we could quantitatively show the state of subjects in trendelenburg position.%現在，外科的治療はより低侵襲なものへと発展しており，その代表としてロボット支援や内視鏡下外科手術がある.これらの手術では特殊体位の保持が求められており，その1つが，仰向けで開脚し頭側へ手術台を傾斜させる頭低位である.患者の多くは長時間同一体位を余儀なくされ，手術中の体位変換や除圧が困難であり，手術体位保持に関連する創傷や障害の発生リスクがある.これらは，患者の回復に大きな影響を及ぼすため，手術中の適切な体位固定や体圧分散が求められる.