郭靓　靳绮

[關键词] 标准化作业清单;手术体位;肱骨骨折;改良侧卧位

[中图分类号] R274.1          [文献标识码] B          [文章编号] 1673-9701（2021）17-0181-03

Application effect of standardized checklist of modified lateral decubitus position in the operation of middle and lower humerus fractures in children

GUO Liang   JIN Qi

Nursing Department， Tianshui First People's Hospital， Tianshui   741000， China

[Abstract] Objective To explore the application effect of standardized checklist of modified lateral decubitus position in the operation of middle and lower humerus fractures in children. Methods A total of 40 children with middle and lower humerus fractures from June 2017 to June 2018 were selected and divided into the observation group （20 cases） and the control group （20 cases） according to the random number table method. The control group was in traditional supine position， and the observation group was in modified lateral decubitus position according to the standardized checklist. Both groups were treated with posterior approach plate internal fixation. The duration of intraoperative nursing， the satisfaction of the surgeon， the anesthesiologist， and the nurse， as well as the incidences of postoperative complications were observed and compared between the two groups. Results The duration of intraoperative nursing in the observation group was significantly shorter than that in the control group， and the difference was statistically significant （P<0.05）. The surgical satisfaction in the observation group was higher than that in the control group， and the difference was statistically significant （P<0.05）. The anesthesiologist satisfaction in the observation group was higher than that in the control group， and the difference was statistically significant （P<0.05）. The nurse satisfaction in the observation group was higher than that in the control group， and the difference was statistically significant（P<0.05）. The incidence of complications in observation group was lower than that in control group， and the difference was statistically significant（P<0.05）. Conclusion The standardized checklist of modified lateral decubitus position is easy to operate in the operation of middle and lower humerus fracture in children， and is beneficial to the operation of surgeons， anesthesiologists and nurses.

[Key words] Standardized checklist; Operative position; Humerus fracture; Modified lateral decubitus position

儿童肱骨中下段骨折临床上较为常见，对于移位的肱骨中下段骨折多采用解剖锁定钢板行内固定治疗[1]。目前临床上采用仰卧位后入路行内固定治疗，存在术者操作不便，患肢压迫胸部、需要助手持续扶持等问题。近年来，改良侧卧位标准化作业在多种手术中的应用效果显著，使用正确的约束方法能够保证患者安全，方便手术医师操作，利于麻醉监护，减轻患者不适感[2]在医学临床中被广泛使用和进一步研究，但是目前国内尚无对于改良侧卧位标准化作业清单在儿童肱骨中下段骨折手术中的应用效果研究。鉴于此，我院自2017年6月至2018年6月应用改良侧卧位标準化作业清单，优化现行的工作方法，规范实施侧卧位安置工作流程，经临床验证效果良好，现在对40例患者的手术情况进行对比，现报道如下。

1 资料与方法

1.1一般资料

本研究共纳入病例40例，并由住院号随机分为观察组、对照组各20例。观察组男11例，女9例;年龄3～14岁，平均（7.6±1.4）岁。对照组男12例，女8例;年龄3～13岁，平均（7.7±1.6）岁。两组患者一般情况比较，差异无统计学意义（P>0.05），具有可比性。入院后予以完善检查化验及术前准备。护理周期均为受伤至手术时间为3～7 d，平均4.5 d。本研究获已得本单位伦理委员会批准，所有患儿监护人均签署知情同意书并授权手术治疗。

1.2 病例纳入与排除标准

病例纳入标准：选择2017年6月至2018年6月3～14岁内的单侧闭合性肱骨中下段骨折的患儿。①……