摘要
目的探讨达芬奇机器人辅助腹腔镜前列腺癌根治术中患者的体位管理策略。方法回顾性分析2017年5月至2019年12月于中山大学孙逸仙纪念医院收治的213例接受达芬奇机器人辅助腹腔镜前列腺癌根治术患者临床资料。对照组86例按常规体位护理,实验组127例设计专项体位管理方案,包括患者评估、体位安置方法、手术中体位的调节、安全预警及加强护理措施。比较两组患者体位摆设用时、手术时间、机器人二次泊位发生率、术者满意度、护理质量观察指标(1期压疮、深静脉血栓指标)。结果213例患者手术均按计划顺利完成。实验组患者体位摆设用时及手术时间明显降低,机械臂碰撞躯体及二次泊位发生率减低,术者满意度明显提升,且差异有统计学意义。两组患者在护理不良事件发生率上亦存在差异,但差异并无统计学意义。结论达芬奇机器人辅助腹腔镜前列腺癌根治手术中科学的体位管理不仅可充分暴露手术部位,为流畅完成手术操作提供保证,提高手术效率,而且可避免患者术中受到损伤以及减少术中、术后并发症的发生,值得临床推广。
Objective To explore the postural management strategy of patients undergoing laparoscopic radical prostatectomy assisted by Da Vinci robot.Methods Clinical data of 213 patients admitted to Sun Yat-sen Memorial Hospital,Sun Yat-sen University from May 2017 to Dec.2019 who received laparoscopic radical prostatectomy assisted by Da Vinci robot were retrospectively analyzed.In the early control group,86 patients received routine postural nursing,while in the late intervention group,127 patients received special postural management plans,including patient evaluation,postural placement method,postural adjustment during surgery,safety warning and nursing measures.The patients in the two groups were compared in terms of positioning time,operation time,incidence of robot second berth,doctor satisfaction,and observation indexes of nursing quality(stageⅠpressure ulcer,deep vein thrombosis).Results All 213 patients completed the operation successfully.In the late intervention group,positioning time and operation time were significantly reduced,the incidence of robotic arm collides with the body and the second berth was also significantly reduced,and the satisfaction of the operator was significantly increased.The difference was statistically significant in the above index.There was also different in the incidence of nursing adverse events between the two groups,but the difference was not statistically significant.Conclusions The scientific position management of Da Vinci robot-assisted laparoscopic radical surgery for prostate cancer can not only fully expose the surgical site,provide guarantee for smooth surgical operation,improve surgical efficiency,but also avoid intraoperative injury and reduce intraoperative and postoperative complications.It is worthy of clinical promotion.
作者
罗敏
盛夏
梁敏
蔡春明
黄海
Luo Min;Sheng Xia;Liang Min;Cai Chunming;Huang Hai(Operation Room,Sun Yan-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,China;Department of Urology,Changhai Hospital of Naval Medical University,Shanghai 200433,China;Department of Urology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,China)
出处
《中华腔镜泌尿外科杂志（电子版）》
2020年第5期330-333,共4页
Chinese Journal of Endourology(Electronic Edition)
基金
广东省护理学会科研立项课题(gdhlxueh2019zx078)。
关键词
达芬奇机器人
腹腔镜
前列腺癌根治术
手术体位
优化
Da Vinci Robot
Laparoscope
Radical prostatectomy
Operative position
Optimization
