目的 分析甲状腺手术体位摆放的最佳时机及其对患者术后不适症的影响.方法 采用前瞻性研究的方法,将2016年1月至2017年10月上海东方肝胆外科医院收治的100例行甲状腺手术治疗的患者,采用随机数字表法分为观察组和对照组,每组各50例,观察组手术体位摆放在麻醉诱导前完成,对照组则在麻醉插管后完成.比较两组患者手术体位维持时间、手术时间、麻醉插管时间,以及颈、肩、腰部疼痛度、咽部疼痛视觉模拟评分(VAS)、咽部不适发生率、恶心呕吐发生级别.结果 观察组手术体位维持时间、手术时间、麻醉插管时间与对照组比较,差异均无统计学意义(P>0.05);观察组颈、肩、腰部Ⅲ+Ⅳ度疼痛率(6.00％)较对照组(20.00％)低;术后咽部VAS较对照组低,咽部不适发生率(26.00％)较对照组(56.00％)低,差异均具有统计学意义(P 0. 05). The rate of III + IV degree of neck,shoulder,waist pain (6. 00％)in observation group was lower than that (20. 00％)of control group. Postoperative pharyngeal VAS scores were lower than those of control group,the incidence of pharyngeal discomfort (26. 00％)was lower than that (56. 00％)of control group,and the difference was statistically significant (P <0. 05). The incidence of nausea and vomiting (6. 00％)was lower than that (20. 00％)of control group,and the difference was statistically significant (P <0. 05). Conclusion Different mainteaining time of surg-ial position may influence postoperative symptoms in patients with thyroid surgery,and the position before anesthesia induction can alleviate postoper-ative neck,shoulder and waist pain,pharyngeal discomfort,alleviate symptoms of nausea and vomiting,and improve the satisfaction of patients.
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