【摘要】 目的 探讨老年肱骨近端骨折假体置换手术围手术期及术中的护理配合。方法 回顾术前、术中、术后的护理措施，总结经验、体会。结果 整个手术过程顺利，患者术后伤口愈合好，全麻过程中监测生命体征平稳。结论 (1)半坐位Codman入路非常适用于肩关节置换手术，术中操作、配合非常方便。(2)45°半坐位摆放过程中分次摇高床头、动态监测生命体征、及时采取相应措施对保证诊疗安全十分重要。(3)45°半坐位体位稳定，无需宽布带固定；且对患者生命体征影响较小。

    【关键词】 体位；手术入路；肱骨近端；骨折；护理

    The nursing of proximal humerus prosthesis replacement via codman approach on semi-recumbent position

    LI Ying，WANG Zhi-qin.Tianjin Hospital，Tianjin 300211，China

    【Abstract】 Objective To discuss the nursing experience of proximal humerus prosthesis replacement in an old patient with humeral fracture.Methods Reviewing the nursing procedures pre-operation，post-operation and during operation，and to sum up the experiences obtained.Results The operation was performed successfully，and the incision healed without infection after operation.The vital signs kept even during anesthesia and operation.Conclusion (1) Codman’s approach is very convenient for shoulder replacement surgery.(2) Gradual lifting of patient’s trunk to 45° recumbent position and dynamic monitoring of vital signs are of great importance.(3) 45° recumbent position is stable enough for the surgery and there is no need for additional belt fastening. ......