目的

探索改良沙滩椅位摆放流程在肩关节手术中的应用效果。

方法

选取2023年1月至2024年6月广州医科大学附属第一医院麻醉手术科34例Ⅲ级、Ⅳ级肩关节手术中应用沙滩椅位的患者为研究对象，收集体位摆放前后的血红蛋白、血氧饱和度、皮肤获得性压力性损伤、出血量、尿量及并发症等数据，比较采用配对样本t检验或Wilcoxon符号秩检验。

结果

34例手术患者均安全顺利完成手术。血红蛋白、血氧饱和度、皮肤获得性压力性损伤术前和术后结果差异无统计学意义（均为P>0.05）。出血量20（9，23）ml，尿量250（0，825）ml，补液量（1 265±699）ml，手术时间为（105±69）min，未发生体位性压迫、神经损伤和下肢静脉血栓。其中13例患者在术中应用有创动脉血压监测。

结论

通过改良沙滩椅位，在保证术野暴露的同时，有效降低了低血压、神经损伤和压力性损伤风险，术后无相关并发症且生理指标稳定，为该类手术的护理提供了可参考的规范。

Objective

To investigate the effectiveness of an improved beach chair position in shoulder joint surgeries.

Methods

Thirty-four patients undergoing grade III and IV shoulder surgeries in the Department of Anesthesia and Surgery of the First Affiliated Hospital of Guangzhou Medical University from January 2023 to June 2024 and placed in the beach chair position were selected as the research objects.Paired sample t test or Wilcoxon signed-rank test was employed for the comparison of the observation indicators before and after the position placement.

Results

All 34 patients successfully completed their surgeries without complications. There was no significant difference in hemoglobin level, oxygen saturation, or incidence of acquired pressure injuries before and after surgery. During surgery, the blood loss was 20(9, 23) ml, and the urine volume was 250(0, 825) ml, fluid intake was (1 265±699) ml, and the surgical duration was (105±69)min. No patient encountered position compression, nerve injury, or lower limb venous thrombosis. Among the patients, 13 underwent invasive arterial blood pressure monitoring during surgery.

Conclusion

The improved“beach chair” position effectively ensures optimal exposure of the surgical field with stable physiological parameters while minimizing the risks of hypotension, nerve and pressure injuries, without postoperative complications, which providing a useful reference for nursing protocols in similar surgeries.