摘要
目的研究加温CO2气腹对达芬奇机器人胰十二指肠切除手术患者预后的影响。方法选取2016年1月至2018年12月行达芬奇机器人胰十二指肠切除手术患者307例作为研究对象,将2016年1月至2017年4月140例患者设为对照组,采用常温CO2气腹;2017年5月至2018年12月167例患者设为干预组,采用加温CO2气腹。比较2组入手术室后、麻醉前、建立CO2气腹前、关闭CO2气腹后的体温、心率、血氧饱和度,记录手术时长、术中失血量、术后麻醉苏醒时长、住院时间以及术后并发症发生率。结果2组入室时体温和建立CO2气腹前体温比较差异无统计学意义(P>0.05);关闭CO2气腹后对照组体温下降幅度明显高于干预组,分别为(1.24±2.36)、(0.60±0.25)℃,差异有统计学意义(t值为6.892,P<0.01);2组手术时长、血氧饱和度<0.90的例数、胃肠瘘及切口感染发生率比较差异无统计学意义(P>0.05);术中出血量干预组为(291.08±265.42)ml,对照组为(364.29±309.28)ml;复苏所用时间干预组(27.04±10.89)min,对照组(32.60±12.17)min;引流管拔除时间干预组(8.69±6.64)d,对照组(10.76±6.25)d,2组比较差异有统计学意义(t值为2.232、7.294、2.789,P<0.05或0.01);胰瘘、胆瘘发生例数及住院时间干预组分别为20例、7例、(27.62±17.30)d,对照组分别为31例、15例、(32.38±12.22)d,2组比较差异有统计学意义(χ2值为4.653、4.870,t值为6.284,P<0.05)。结论加温CO2气腹可减少达芬奇机器人胰十二指肠切除手术患者围手术期低体温的发生率,改善患者预后。
Objective To study the effect of heated carbon dioxide pneumoperitoneum on the prognosis of patients undergoing pancreaticoduodenectomy by Da Vinci robot.Methods A total of 307 patients who underwent pancreaticoduodenectomy by Da Vinci robot from January 2016 to December 2018 were selected as subjects.140 patients who underwent pancreaticoduodenectomy from January 2016 to April 2017 were selected as the control group,and room temperature carbon dioxide pneumoperitoneum was used.From May 2017 to December 2018,167 patients were set as the intervention group,and heated carbon dioxide pneumoperitoneum was used.Body temperature,heart rate and blood oxygen saturation of the two groups were compared after entering the operating room,before anesthesia,before the establishment of carbon dioxide pneumoperitoneum and after the closure of carbon dioxide pneumoperitoneum,and the duration of operation,intraoperative blood loss,postoperative anesthesia recovery time,hospitalization time and postoperative complication rate were recorded.Results There was no significant difference in body temperature after entering the operating room,before the establishment of carbon dioxide pneumoperitoneum between the two groups(P>0.05).After the closure of carbon dioxide pneumoperitoneum,the decline range of the body temperature of the control group was(1.24±2.36)℃,which was significantly higher than that of the intervention group(0.60±0.25)℃,and the difference was statistically significant(t value was 6.892,P<0.05).There were no statistically significant differences between the two groups in terms of operation duration,number of cases with blood oxygen saturation<0.90,incidence of gastrointestinal fistula and incision infection(P>0.05).The intraoperative blood loss,resuscitation time,drainage time was(291.08±265.42)ml,(27.04±10.89)min,(8.69±6.64)d in the intervention group and(364.29±309.28)ml,(32.60±12.17)min,(10.76±6.25)d in the control group,and the difference was statistically significant(t value was 2.232,7.294,2.789,P<0.05
作者
陈沅
沈洁芳
钱蒨健
王维
龚茹洁
Chen Yuan;Shen Jiefang;Qian Qianjian;Wang Wei;Gong Rujie(Department of Operation Room,Ruijin Hospital Affiliated to Shanghai Jiaotong University Medical School,Shanghai 200025,China)
出处
《中国实用护理杂志》
2020年第10期761-764,共4页
Chinese Journal of Practical Nursing
关键词
加温CO2气腹
达芬奇机器人
胰十二指肠切除手术
预后
低体温
Warming carbon dioxide pneumoperitoneum
Da Vinci robot
Pancreaticod-uodenectomy
Prognosis
Hypothermia
