手术室中的人体工程学
Ergonomics in the operating room.
作者信息
Janki Shiromani, Mulder Evalyn E A P, IJzermans Jan N M, Tran T C Khe
机构信息
Division of HPB and Transplant Surgery, Erasmus MC, Department of Surgery, University Medical Center, Room no. H-822k, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
出版信息
Surg Endosc. 2017 Jun;31(6):2457-2466. doi: 10.1007/s00464-016-5247-5. Epub 2016 Oct 17.
BACKGROUND
Since the introduction of minimally invasive surgery, surgeons appear to be experiencing more occupational musculoskeletal injuries. The aim of this study is to investigate the current frequency and effects of occupational musculoskeletal injuries on work absence.
METHODS
An online questionnaire was conducted among all surgeons affiliated to the Dutch Society for Endoscopic Surgery, Gastrointestinal Surgery, and Surgical Oncology. In addition, this survey was conducted among surgeons, gynaecologists, and urologists of one cluster of training hospitals in the Netherlands.
RESULTS
There were 127 respondents. Fifty-six surgeons currently suffer from musculoskeletal complaints, and 30 have previously suffered from musculoskeletal complaints with no current complaints. Frequently reported localizations were the neck (39.5 %), the erector spinae muscle (34.9 %), and the right deltoid muscle (18.6 %). Most of the musculoskeletal complaints were present while operating (41.8 %). Currently, 37.5 % uses medication and/or therapy to reduce complaints. Of surgeons with past complaints, 26.7 % required work leave and 40.0 % made intraoperative adjustments. More surgeons with a medical history of musculoskeletal complaints have current complaints (OR 6.1, 95 % CI 1.9-19.6). There were no significant differences between surgeons of different operating techniques in localizations and frequency of complaints, or work leave.
CONCLUSIONS
Despite previous various ergonomic recommendations in the operating room, the current study demonstrated that musculoskeletal complaints and subsequent work absence are still present among surgeons, especially among surgeons with a positive medical history for musculoskeletal complaints. Even sick leave was necessary to fully recover. There were no significant differences in reported complaints between surgeons of different operating techniques. Almost half of the respondents with complaints made intraoperative ergonomic adjustments to prevent future complaints. The latter would be interesting for future research.
背景
自从引入微创手术以来，外科医生似乎正遭受更多职业性肌肉骨骼损伤。本研究的目的是调查职业性肌肉骨骼损伤的当前发生率及其对缺勤的影响。
方法
对荷兰内镜外科学会、胃肠外科学会和外科肿瘤学会的所有外科医生进行了一项在线问卷调查。此外，还对荷兰一组教学医院的外科医生、妇科医生和泌尿科医生进行了此项调查。
结果
共有127名受访者。目前有56名外科医生患有肌肉骨骼疾病，30名曾患过肌肉骨骼疾病但目前无相关症状。经常报告的患病部位是颈部（39.5%）、竖脊肌（34.9%）和右三角肌（18.6%）。大多数肌肉骨骼疾病症状出现在手术过程中（41.8%）。目前，37.5%的人使用药物和/或治疗来减轻症状。有既往病史的外科医生中，26.7%需要请假，40.0%在术中进行了调整。有肌肉骨骼疾病病史的外科医生中，目前仍有症状的比例更高（比值比6.1，95%置信区间1.9 - 19.6）。不同手术技术的外科医生在患病部位、症状发生率或请假情况方面没有显著差异。
结论
尽管此前在手术室提出了各种人体工程学建议，但当前研究表明，外科医生中仍存在肌肉骨骼疾病症状及随后的缺勤情况，尤其是有肌肉骨骼疾病阳性病史的外科医生。甚至需要病假才能完全康复。不同手术技术的外科医生在报告的症状方面没有显著差异。几乎一半有症状的受访者在术中进行了人体工程学调整以预防未来出现症状。这一点对于未来研究将很有意思。
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