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目的通过对在陆地和不同摇摆度模拟器内开展脾切除术和胸腔闭式引流术进行对比研究,初步了解不同海况下卫生船舶内完成胸腹部手术情况及完成手术用时变化,为评估卫生船舶战时救治能力提供参考。方法通过Delphi法,咨询全军野战外科专业15名专家,通过3轮咨询,筛选出脾切除术和胸腔闭式引流术做为胸腹部急救手术的代表术式。20只成年杂种犬随机分成A组(陆基组)、B组(2级海况组)、C组(5级海况组)、D组(8级海况组),每组5只,行脾切除术和胸腔闭式引流术,记录手术完成情况及所用时间(s),同时记录实验过程中手术人员反应和影响手术完成的因素。结果 4组手术均顺利完成,B、C组完成脾切除术用时与A组无统计学差异(P>0.05),D组完成脾切除术用时与B、C组有统计学差异(P<0.05),与A组比较有非常显著差异(P<0.01)。而各组行胸腔闭式引流术所用时间均无统计学差异(P>0.05)。实验过程中,手术人员轻度头晕,但对完成手术操作无明显影响。结论卫生船舶在8级以下海况条件,手术人员可顺利完成胸腹部急救手术,当摇摆幅度较大时,完成复杂手术难度及手术用时相应增加,而对简单操作影响不大。
Objective To compare the performance of splenectomy and thoracic closure drainage in terrestrial and different swing simulators to get a preliminary understanding of the status of thoracoabdominal and abdominal surgery performed in hygienic vessels under different sea conditions and to evaluate the changes of sanitary vessel warfare When the treatment capacity to provide a reference. Methods Through the Delphi method, we consulted with 15 experts in the Field Army Surgical Surgery. Through 3 rounds of consultation, we screened splenectomy and closed thoracic drainage as the representative surgical procedures for thoracoabdominal and abdominal emergency. Twenty adult mongrel dogs were randomly divided into three groups: group A (land group), group B (group 2), group C (group 5), group D (group 8) Closed surgery and thoracic drainage, recording the completion of surgery and the use of time (s), while recording the reaction of the surgical staff during the experiment and affect the operation of the completion of the factors. Results The operation of 4 groups was successfully completed. There was no significant difference between group B and group C when using splenectomy (P> 0.05). Group D was significantly different from group B and C (P <0.05) ), There is a very significant difference compared with the A group (P <0.01). There was no significant difference between the two groups in the time of closure of thoracic drainage (P> 0.05). During the experiment, the operatives mild dizzy, but no significant effect on the completion of the operation. Conclusion Under the condition of sea level below 8th grade, the operating personnel can successfully perform the emergency treatment of chest and abdomen. When the swing amplitude is large, the complexity of operation and the time of operation increase correspondingly, but it has little effect on the simple operation.