手助腹腔镜在胃贲门癌根治术中的手术配合  

Operative cooperation of hand-assisted laparoscopic radical resection of gastric cardia cancer

作　　者：刘伟[1] 王占文 仲丽静 茹丽娜 李彦平[1] 李涛[1] 张占学[1] LIU Wei;WANG Zhanwen;ZHONG Lijing(The Second Hospital of Hebei Medical University,Hebei,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院,石家庄市050000 [2]河北省石家庄市第五医院 [3]河北省石家庄市第四医院

出　　处：《河北医药》2018年第22期3501-3504,共4页Hebei Medical Journal

摘　　要：目的探讨手助腹腔镜在胃贲门癌手术中的优势及护理配合特点。方法 78例胃贲门患者,被随机分为手助腹腔镜组、腹腔镜组和开腹组,每组26例,总结手助腹腔镜手术效果及在术前、术中、术后的配合经验。结果78例患者均顺利完成手术,无中转开腹。手助腹腔镜组与开腹组在手术出血量、切口长度、术后开始排气的时间、进食时间、镇痛时间、住院时间等方面差异有统计学意义(P <0. 05),在手术时间差异无统计学意义(P> 0. 05);手助腹腔镜组较腹腔镜辅助组在手术时间差异有统计学意义(P <0. 05),在手术出血量、切口长度、术后开始排气的时间、进食时间、镇痛时间、住院时间方面差异无统计学意义(P> 0. 05)。结论手助腹腔镜手术在胃贲门癌手术安全可靠;术中巡回护士在术中配合要关注手术操作过程,及时补充所需物品,注意观察腹压变化;器械护士熟悉手术程序,了解手助器的结构和使用方法,在手术过程中要注意"无瘤"观念,可使手术的顺利进行并取得满意的手术效果。Objective To investigate the advantages of hand-assisted laparoscopic surgery in treatment of gastric cardia cancer and the characteristics of nursing cooperation.Methods A total of 78 patients with gastric cardia cancer who were treated in our hospital from April 2015 to April 2018 were randomly divided into 3 groups:hand-assisted laparoscopic group,laparoscopy group and laparotomy group,with 26 patients in rach group.The effects of hand assisted laparoscopic surgery and the experience of cooperation in preoperative,intraoperative and postoperative periods were observed and compared among the three groups.Results All the 78 patients underwent the operation successfully without conversion to laparotomy.There were significant differences in intraoperative bleeding volume,incision length,postoperative exhaust time,eating time,analgesia time and hospitalization time between hand-assisted laparoscopic group and laparotomy group(P>0.05),there was no significant difference in operation time between the two groups(P>0.05).However there was significant difference in operation time between hand-assisted laparoscopic group and laparoscopy group(P<0.05),but there were no significant differences in intraoperative bleeding volume,incision length,postoperative exhaust time,eating time,analgesia time and hospitalization time between hand-assisted laparoscopic group and laparoscopy group(P>0.05).Conclusion Hand-assisted laparoscopic surgery is safe and reliable in treatment of gastric cardia cancer.The cooperation of circuiting nurses during operation should replenish the items in time and observe the changes of abdominal pressure.The instrument nurses must be familiar with the procedure of operation and understand the structure and usage of the hand-assisted instrumens.In the process of operation,it should be paid much attention to the“tumor free”concept,which can make the operation go smoothly and achieve satisfactory results.

关 键 词：手助腹腔镜 贲门癌 手术配合 护理 无瘤技术 

分 类 号：R472.3[医药卫生—护理学]