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中华肥胖与代谢病电子杂志 ›› 2021, Vol. 07 ›› Issue (01) : 41 -46. doi: 10.3877/cma.j.issn.2095-9605.2021.01.008

所属专题: 文献

论著

超级肥胖患者腹腔镜代谢手术的手术室护理操作要领
公凤霞1, 赵赏1, 曹李1, 董光龙1,()   
  1. 1. 100853 北京,解放军总医院第一医学中心普通外科
  • 收稿日期:2020-08-21 出版日期:2021-02-28
  • 通信作者: 董光龙
  • 基金资助:
    国家自然科学基金面上项目(81773247)

Operating room risk management strategies for laparoscopic metabolic surgery in super obese patients

Fengxia Gong1, Shang Zhao1, Li Cao1, Guanglong Dong1,()   

  1. 1. Department of General Surgery, First Medical Center, General Hospital of PLA, Beijing 100853, China
  • Received:2020-08-21 Published:2021-02-28
  • Corresponding author: Guanglong Dong
引用本文:

公凤霞, 赵赏, 曹李, 董光龙. 超级肥胖患者腹腔镜代谢手术的手术室护理操作要领[J]. 中华肥胖与代谢病电子杂志, 2021, 07(01): 41-46.

Fengxia Gong, Shang Zhao, Li Cao, Guanglong Dong. Operating room risk management strategies for laparoscopic metabolic surgery in super obese patients[J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2021, 07(01): 41-46.

目的

探讨超级肥胖患者腹腔镜代谢手术中手术室护理操作要领。

方法

分析我院2016年1月至2020年1月实施的30例超级肥胖患者的腹腔镜代谢手术的手术室中遇到的相关风险因素与采取的相应解决措施,提出较安全、精准、完善的超级肥胖患者手术室护理操作要领。

结果

通过处理导尿困难、外周静脉穿刺及中心静脉置管困难、血压监测困难、体位放置和固定困难等手术室护理困难,建立了针对降低超级肥胖患者腹腔镜代谢手术的手术室风险的对策和管理模式,保证手术顺利进行,减少围手术期并发症的发生。

结论

超级肥胖患者的腹腔镜代谢手术较一般体重患者存在极大的手术室管理风险。手术室风险的处理,相关护理风险的有效控制和完善管理模式的建立有助于保障手术顺利进行,减少手术相关并发症的发生,是腹腔镜减肥代谢手术成功的重要保证。

Objective

The project is conducted to explore risks, characteristics and countermeasures during laparoscopic metabolic surgery for super-obese patients at operating rooms.

Methods

Relevant risk factors and countermeasures arising from laparoscopic metabolic surgery for 30 super-obese patients at operating rooms of the hospital between January 2016 and January 2020 were studied. On this basis, safe, accurate and perfect operating room risk controlling and management schemes were proposed.

Results

Countermeasures and management patterns, designed to minimize operating room risks during laparoscopic metabolic surgery for super-obese patients, ensure smooth progress of operation and reduce periprocedural complications, were established through effective countermeasures for problems with urethral catheterization, peripheral venipuncture, central-vein catheterization,blood pressure monitoring, body positioning and immobilization as well as other problems with operating room nursing.

Conclusions

Compared with patients of average weight, super-obese patients will face much more operation room management risks. The treatment with operation room risks, effective control of relevant nursing risks and the establishment of improved management patterns will contribute to smooth surgical progress, minimize operation-related complications and ensure the success of laparoscopic metabolic surgery for weight loss.

表1 患者术前基本资料
表2 导尿术及相关并发症
表3 外周和深部静脉穿刺及相关并发症
表4 手术相关资料
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