目的 分析“侧俯卧位”MRI引导腰脊神经后根神经节脉冲射频治疗腰椎间盘突出症的手术体位护理效果。方法 对2018年9月—2020年12月在广州市荔湾中心医院住院接受经MRI引导腰脊神经后根神经节脉冲射频的腰椎间盘突出症患者62例随机分为两组：侧俯卧位组和俯卧位组,每组各31例。侧俯卧位组采用患侧抬高约30 °的侧俯卧位手术,俯卧位组采用标准俯卧位手术。记录两组手术时间、手术并发症、手术体位相关并发症及术者对术野显露的满意度评价。结果 所有患者均顺利完成手术,未见出血、感染、下肢麻痹加重神经损伤、脏器损伤等手术并发症,无患者发生眼压增高、臂丛损伤、压疮等体位相关并发症。侧俯卧位组手术时间（60.65±12.45）min,俯卧位组手术时间（70.58±10.25） min,组间比较差异有统计学意义（t=3.429,P=0.001）。术者对侧俯卧位组和俯卧位组术野侧显露总满意度分别为93.55%和77.42%,组间比较差异有统计学意义（χ²=4.292,P=0.038）。结论 侧俯卧位MRI引导腰脊神经后根神经节脉冲射频治疗腰椎间盘突出症安全、有效,做好手术体位护理可有效防止并发症。

Objective To analyze the effect of surgical position nursing for radiofrequency ablation in posterior root ganglion in lumbar spinal nerve guided by MRI in lateral prone position．Methods Sixty-two patients with lumbar disc herniation hospitalized in Liwan Central Hospital of Guangzhou from September 2018 to December 2020 were randomly divided into two groups（the lateral prone position group and the prone position group,31 patients in each group）．The lateral prone position group used the lateral prone position with about 30 degrees elevation of the affected side,and the prone position group used the standard prone position for operation．Operating time,surgical complications,surgical position related complications,and operator satisfaction evaluation of surgical field exposure were recorded in both groups．Results All patients completed the operation successfully．No surgical complications such as bleeding,infection,lower limb paralysis,aggravated nerve injury or organ injury were found in the two groups．No surgical position related complications such as intraocular pressure raising,brachial plexus injury or pressure ulcers in both the groups either．The operation time was（60.65±12.45）min in the lateral prone position group and（70.58±10.25）min in the standard prone position group,respectively,and the difference was statistically significant（t=3.429,P=0.001）．The surgeon’s satisfaction evaluation of the surgical field exposure was much higher in the lateral prone position group（93.55%）compared with the standard prone position group（77.42%）,and the difference was statistically significant（χ²=4.29,P=0.038）．Conclusions Radiofrequency ablation in posterior root ganglion of lumbar spinal nerve guided by MRI in lateral prone position is safe and effective．Good surgical position nursing can effectively prevent complications．

目的 探讨责任制助产护理模式配合体位管理对高龄产妇分娩方式及产程的影响。方法 选择2023年6月—12月医院接收的高龄产妇68例进行研究，按照护理方式分为两组各34例，对照组为常规助产护理，观察组为责任制助产护理模式配合体位管理，比较两组分娩方式、产程、疼痛程度及护理满意度。结果 观察组阴道分娩率为76.47%（26例），高于对照组52.94%（18例），剖宫产率为8.82%（3例），低于对照组29.41%（10例）（χ2分别为4.121、4.660，均P＜0.05）。观察组第一产程（6.25±0.50）h、第二产程（0.79±0.21）h、总产程（7.15±0.63）h、宫口开大3 cm、10 cm时的疼痛程度（4.12±1.08）分、（6.29±1.25）分明显低于对照组（7.01±0.62）h、（0.96±0.30）h、（8.11±1.07）h、（7.84±1.45）分、（9.09±0.74）分（t分别为5.563、2.706、4.508、11.997、11.239，均P＜0.05）。观察组的护理满意度为97.06%（33例），比对照组的76.47%（26例）高（χ2=4.610，P=0.031）。结论 高龄产妇展开责任制助产护理模式配合体位管理可促进自然分娩，并缩短产程，减轻产时疼痛程度，降低剖宫产率，提高护理满意度。

Objective To explore the effect of responsibility midwifery nursing model combined with position management on delivery mode and labor process of elderly parturient．Methods A total of 68 cases of elderly pregnant women admitted to the hospital from June to December 2023 were selected,and they were divided into two groups according to the nursing mode,34 cases in each group．The control group was given routine midwifery nursing,and the observation group was given responsible midwifery nursing mode combined with position management．The methods of delivery,labor process,pain degree and nursing satisfaction of the two groups were compared．Results The vaginal delivery rate was 76.47%（26 cases）in the observation group,which was higher than 52.94%（18 cases）in the control group,and the cesarean section rate was 8.82%（3 cases）in the observation group,which was lower than 29.41%（10 cases）in the control group（χ²=4.121 and 4.660,P=0.042 and 0.030）．The pain degree of the first stage of labor（6.25±0.50）h,the second stage of labor（0.79±0.21）h,the total stage of labor（7.15±0.63）h,the pain degree of the cervical dilation 3 cm,10 cm in the observation group were significantly lower than those in the control group[（7.01±0.62）h,（4.12±1.08）points,（6.29±1.25）points vs （0.96±0.30）h,（8.11±1.07）h,（7.84±1.45）score,（9.09±0.74）score（t=5.563,2.706,4.508,11.997,11.239,P<0.05）．The nursing satisfaction of the observation group was 97.06%（33 cases）,which was higher than 76.47%（26 cases）of the control group（χ²=4.610,P=0.031）．Conclusion sResponsibility midwifery nursing mode combined with position management can promote natural childbirth,shorten the labor process,reduce the pain during labor,reduce the rate of cesarean section,and improve nursing satisfaction in elderly women,which is worthy of promotion．

目的 氧气雾化吸入体位对颈椎前路减压植骨融合术后吞咽困难的影响。方法 将在2017年2月—2019年10月期间行颈椎前路减压植骨融合术患者(2～3节段)123例随机分成两组:A组(n=56,半卧位行氧气雾化), B组(n=67,平卧位行氧气雾化)。比较两组术后吞咽困难发生及程度、持续时间情况和患者对氧气雾化吸入方法满意度。结果 A组术后吞咽困难发生率低于B组(P=0.042),并且吞咽困难程度动态变化中总体优于B组;两组吞咽困难持续时间无统计学差异(P=0.826)。A组患者对氧气雾化吸入方法满意度优于B组患者(P=0.022)。结论 半卧位氧气雾化吸入能降低颈椎前路术后吞咽困难的发生及严重程度。

Objective To investigate the effect of aerosol inhalation position on dysphagia after multi-segment anterior cervical decompression and bone graft fusion. Methods 123 patients undergoing anterior cervical decompression and bone graft fusion during February 2017 to October 2019 were randomly divided into two groups: group A (n=56, aerosol inhalation in semireclining position), group B (n=67, aerosol inhalation in the supine position). The incidence, extent and duration of dysphagia were compared between the two groups. Results The incidence of postoperative dysphagia in group A was lower than that in group B (P=0.042), and the degree of dysphagia were better than that in group B in the dynamic changes. There was no statistical difference in the duration of dysphagia between the two groups (P=0. 826). Patients in group A had greatly better satisfaction with the aerosol inhalation position than patients in group B (P=0.022). Conclusion Aerosol inhalation in semireclining position can reduce the incidence and severity of dysphagia after anterior cervical spine surgery.

目的 探讨自由体位分娩方式和传统体位分娩方式对产后盆底功能的影响。方法 2015年3月—2016年3月在广州市妇女儿童医疗中心定期产检并分娩单胎初产阴道分娩610例产妇,按分娩方式分为自由体位分娩298例为实验组,传统体位分娩312例为对照组,对两组产妇会阴损伤,产后6～8周筛查盆底肌力,探讨不同体位分娩方式对产后盆底肌力的影响。结果 实验组阴道静息压,阴道收缩压、Ⅰ类肌纤维强度、 Ⅱ类肌纤维强度、阴道收缩持续时间均较对照组有增加,差异性均有统计学意义(P<0.05)。结论 自由体位分娩方式不降低产后盆底肌力,对产后盆底有保护作用。

Objective To analyze the effects of liberal intrapartum postures on the pelvic floor function of postpartum. Methods 610 pregnant women (vaginal delivery,single birth,and head position) were classified and analyzed in Guangzhou Women and Children Medical Center from March 2015 to March 2016. All the pregnant women were mature without pregnancy complications; 298 pregnant women who adopted free posture delivery were selected as observation group,312 pregnant women who adopted traditional posture delivery were selected as control group. We counted the number of perineal injury incidence of the two group,and the pelvic floor strength of the two groups was measured after fetal birth after 6 to 8 weeks. Results We compared the vaginal resting pressure(VRP),vaginal squeezing pressure(VSP),classⅠfiber strength, class Ⅱ fiber strength and the time of vaginal contraction between the two groups. Pelvic floor muscle strength was significantly stronger in the observation group than that in the control group (P<0. 05). Conclusion There is a closely association between the different intrapartum postures and the pelvic floor function of postpartum. Adopting free posture delivery has no adverse impact on pelvic floor function of postpartum, which can protect the function of female pelvic floor.