Abstract:

Objective To design an automatic vaginal retractor with suction and to evaluate its effects of clinical application. Methods An automatic vaginal retractor with suction was designed and manufactured. 100 patients diagnosed with high-grade cervical squamous intraepithelial carcinoma（HSIL） and admitted for cervix cold knife conization were enrolled between March and November 2019 in a tertiary obstetrics and gynecology hospital in Zhejiang Province. 50 patients were designated randomly into an experimental group applied with the automatic vaginal retractor with suction during the surgery;L shaped vaginal retractor was used in other 50 patients designated into the control group. Medical staff number （surgeons and nurses） needed for conization,operation time,intraoperative blood loss,incidence of perioperative complication and medical staff satisfaction were evaluated. Results Staff（surgeons and nurses） number in conization during the use of the vaginal automatic retractor with suction was 1-2 instead of 3 in the control group during the use of L shaped vaginal retractor（t=-23.19,P<0.001）. The experimental group applied with automatic vaginal retractor with suction had significantly shorter total operation time（26.20±7.75 min vs 36.28±9.66 min）（t=-5.75,P<0.001）,lower intraoperative blood loss（31.20±19.75 ml vs 48.50±32.12 ml）（t=-3.244,P=0.002）in comparison with those in the control group with the L shaped vaginal retractor,no perioperative complication was observed in either group. Conclusion The automatic vaginal retractor with suction can save medical human resources,reduce operation time and intraoperative blood loss in the cervix cold knife conization,and offer protection for medical staff and patients by automatic suction of blood in operation area and surgical smoker.

Key words: Transvaginal Surgery, Automatic Retractor, Perioperative Nursing

摘要：

目的 设计吸引式阴道自动牵开器,并评价其应用效果。 方法 吸引式阴道自动牵开器由冲洗接头、冲洗管、固定叶片等13个部分组成。选取2019年3月—11月就诊于浙江省某三级甲等妇产专科医院的宫颈高级别上皮内病变且拟行经阴道宫颈冷刀锥形切除手术的100例患者为研究对象,每组各50例。试验组进行阴道手术时采用吸引式阴道自动牵开器,对照组采用传统的L型拉钩。比较两组手术参与人员数量、手术时间,患者术中出血量、患者术中并发症的发生率及医护人员满意度。 结果 试验组所需手术人员1~2名,对照组为3名,差异具有统计学意义（t=-23.19,P<0.001）;试验组手术时间为（26.20±7.75） min,低于对照组的（36.28±9.66） min,差异具有统计学意义（t=-5.75,P<0.001）;试验组术中出血量为（31.20±19.75） ml,低于对照组的（48.50±32.12） ml,差异具有统计学意义（t=-3.244,P=0.002）;所有患者均未发生术后相关并发症。 结论 吸引式阴道自动牵开器能有效节约人力资源,缩短手术时间、减少患者术中出血,并同时吸除手术区域血液和电外科烟雾,保障医护人员及患者安全。

关键词: 经阴道手术, 自动牵开器, 围手术期护理