达芬奇机器人联合西门子Artis Zeego“一站式”Hybrid手术在肺磨玻璃样病变术前定位中临床应用及效果  

Clinical application and effect of Da Vinci robot combined with SIEMENS Artis Zeego “onestop” Hybrid surgery in the preoperative localization of lung ground-glass like lesions

作　　者：邵兵[1] 郑晶晶 李思阳[1] SHAO Bing;ZHENG Jing-jing;LI Si-yang(Operation Room of Anesthesiology,The General Hospital of Shenyang Military Command,Shenyang 110016,China)

机构地区：[1]沈阳军区总医院麻醉科手术室,辽宁沈阳110016

出　　处：《创伤与急危重病医学》2018年第1期18-20,24,共4页Trauma and Critical Care Medicine

基　　金：ERAS在外科重大腔镜手术围术期应用及限制性关键因子的前瞻性研究;辽宁省自然科学基金项目(20170540930)

摘　　要：目的总结达芬奇机器人联合西门子Artis Zeego"一站式"复合手术在肺磨玻璃样病变术前定位中应用的方法和疗效。方法将沈阳军区总医院胸外科自2012年1月至2014年6月先经放射诊断科术前局麻下定位磨玻璃样病变、再转送手术室实施机器人辅助病灶切除手术的30例患者设为A组,将自2014年7至2017年6月在"一站式"复合手术室行全麻下先经西门子Artis Zeego系统引导、亚甲蓝精准定位后实施达芬奇机器人辅助下肺病灶楔形切除的30例患者设为B组。两组患者均根据术中快速冰冻结果回报,决定下一步手术方式。记录并比较两组患者麻醉诱导前生命体征变化、焦虑情况及手术时间。结果麻醉诱导前B组患者的血压为(127.43±6.80)/(97.40±3.94)mm Hg、心率(95.53±5.21)次/min、平均Zung焦虑自评量表(SAS)评分(51.53±2.61)分,A组患者的血压为(131.33±3.25)/(101.83±5.71)mm Hg、心率(104.17±3.77)次/min、平均SAS评分(57.03±2.54)分,两组间比较,差异均有统计学意义(P<0.05)。B组患者各时间点焦虑值及焦虑时间明显低于A组,差异有统计学意义(P<0.05)。B组手术时间明显短于A组,差异有统计学意义(P<0.05)。结论 "一站式"复合手术室结合CT及数字减影血管造影引导亚甲蓝定位、联合达芬奇手术系统可以安全、高效、微创、准确地完成手术治疗,对于切除肺小结节及磨玻璃样病变有一定的价值。Objective To summarize the clinical application and effect of Da Vinci robot combined with SIEMENS Artis Zeego“one-stop”composite surgery in the preoperative localization of lung ground-glass like lesions.Methods There were 30 cases of patients underwent preoperative localization of ground-glass like lesion under local anesthesia in radiology department before being transferred to the operation room for robot assisted lesion resection during January 2012 to June 2014 were divided into Group A;the other 30 cases of patients who received methylene blue lesion precise localization guided by SIEMENS Artis Zeego system in the one-stop hybrid operation room under general anesthesia before the implementation of Da Vinci robot assisted wedge lung lesion resection during July 2014 to June 2017 were in Group B.The surgical procedure was determined by the intro-operative fast frozen section results,and the patients′clinical outcomes were compared between the two groups.The changes of vital signs,anxiety and operation time were compared between the two groups.Results Before anesthesia induction,in Group B,BP was(127.43±6.80)/(97.40±3.94)mmHg,HR was(95.53±5.21)times per minute,SAS score was(51.53±2.61)on arerage,while in Group A,BP was(131.33±3.25)/(101.83±5.71)mmHg,HR was(104.17±3.77)times per minute and SAS score was(57.03±2.54)on arerage,there was statistically significant difference between the two groups(P<0.05).The duration of anxiety in Group B was significantly shorter than that in Group A(P<0.05).The operation time in Group B was significantly shorter than that in Group A(P<0.05).Conclusion One-stop hybrid operation room with CT and DSA guided methylene blue positioning,combined with Da Vinci surgical system can perform surgery safely,accurately and effectively with minimal invasion,especially in the resection of small nodules and ground-glass like lesions of the lung.

关 键 词：达芬奇机器人 西门子Artis Zeego “一站式”复合手术 术前定位 

分 类 号：R734.2[医药卫生—肿瘤]