经皮椎体成形手术体位对患者生命体征和血氧饱和度的影响

背景：尽管有学者肯定了侧卧位行经皮椎体成形的效果及安全性,但对于手术体位在术中对生命体征影响变化尚未见报道。目的：观察经皮椎体成形手术中不同体位对患者生命体征和血氧饱和度的影响。方法：将30例胸腰椎骨质疏松性压缩骨折患者随机分组为2组,分别以俯卧位和侧卧位行经皮椎体成形手术。观察并记录患者在术前仰卧位（T1）、转变手术体位后5min（T2）、穿刺进针过程（T3）、注射骨水泥过程（T4）、骨水泥注射结束（T5）和术后仰卧5min（T6）生命体征和血氧饱和度的变化。结果与结论：俯卧位组T1、T2、T3、T4、T5时间点心率、呼吸频率均高于侧卧位组（P〈0.05）。俯卧位组T2、T3时间点收缩压高于侧卧位组（P〈0.05）。俯卧位组T5时间点血氧饱和度低于侧卧组（P〈0.05）。说明行经皮穿刺椎体成形手术时采用侧卧位较俯卧位对患者生命体征和血氧饱和度的影响小,且侧卧位有利于提高患者手术耐受性。

Effects of body position on vital signs and blood oxygen saturation of patients during percutaneous vertebroplasty

BACKGROUND：Although some scholars have affirmed the effect and safety of lateral position for percutaneous vertebroplasty. But impact of surgical position on the changes in the vital signs during the operation has not been reported. OBJECTIVE：To observe the effects of different body position in vital signs and blood oxygen saturation of patients during percutaneous vertebroplasty. METHODS：Thirty cases of thoracolumbar osteoporotic vertebral compression fractures（OVCF） were divided into two groups randomly：the prone position group（15 cases） and the lateral position group（15 cases） ,both of them are given local anesthesia for percutaneous vertebroplasty. Record of vital signs and blood oxygen saturation for each patient in the following time points were observed,including supine position before surgery（T1） ,5 minutes after body position changing（T2） ,the process of needle puncturing（T3） ,the process of injection of bone cement（T4） ,at the end of bone cement injection（T5） ,the supine position after surgery for 5 minutes（T6） . RESULTS AND CONCLUSION：In the prone position group,the heart rate and respiratory rate were higher than those of the lateral position group（P〈0.05） in the time points including T1,T2,T3,T4,T5. The artery systolic pressure in the prone position group was lower than that of the lateral position group（P〈0.05） in the time points including T2,T3. The blood oxygen saturation in the prone position patients group was lower than that of the lateral group（P〈0.05） in the T5 time point. The above shows that the lateral position has less effect on the patient＇s vital signs and oxygen saturation than the prone position,which is also conducive to improve the tolerance operation of patients during the percutaneous vertebroplasty.