手术机器人辅助下后侧入路腰椎间融合的术中护理配合  

Intraoperative nursing cooperation in orthopaedic robot-assisted PLIF surgery

作　　者：梁敏[1] 黄浚燊 张春燕[1] 李玉希[2] 黄霖[2] LIANG Min;HUANG Junshen;ZHANG Chunyan;LI Yuxi;HUANG Lin(Department of Operating Room,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,China;Department of Orthopaedics,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,China)

机构地区：[1]中山大学孙逸仙纪念医院手术室,广东广州510120 [2]中山大学孙逸仙纪念医院骨科,广东广州510120

出　　处：《机器人外科学杂志（中英文）》2020年第3期202-211,共10页Chinese Journal of Robotic Surgery

基　　金：广东省自然科学基金(2017A030310554,2020A1515010371和2017A030313652)。

摘　　要：目的:探讨手术室护士在骨科手术机器人辅助下后侧入路腰椎间融合术中的护理配合。方法:选取2018年8月~2018年10月中山大学孙逸仙纪念医院运用XGK-6508A智能骨科微创手术系统辅助完成后侧入路腰椎间融合术的3例患者,术中均采用骨科手术机器人辅助行后侧入路椎弓根钉置入和人手椎弓根钉棒内固定+椎管减压+椎间Cage植骨融合术,同时回顾同时期非机器人辅助手术病例4例。手术室护士完成术前手术模拟演练、患者准备、手术间、仪器及物品准备与检查,术中完成设备安置、对接、管理和手术医生配合应用等。观察所有患者的住院天数、手术时间、术中出血量、置钉数、手术前后总曝光次数、手术前注册曝光次数、手术中验证曝光次数和手术费用。结果:机器人组和非机器人组的置钉数分别为(5.00±1.00)个和(5.00±1.15)个,术中出血量两组分别为(216.67±246.64)ml和(262.50±249.58)ml,住院天数分别为(17.33±4.51)d和(18.50±6.76)d,以上指标两组之间均无统计学差异(P>0.05);手术时间分别为(285.00±44.44)min和(196.25±85.09)min,手术曝光次数分别为(9.00±3.00)次和(4.75±0.50)次,手术费用分别为(15634.17±7218.14)元和(12130.50±1478.62)元,以上指标两组之间差异具有统计学意义(P<0.05)。结论:机器人辅助手术具有巨大的潜力,在完善的术前准备、掌握患者情况的前提下,熟练掌握手术机器人系统的连接、器械的使用,熟悉手术步骤,医护人员配合默契,经专业技术培训的专业团队合作,是手术顺利完成的关键。Objective:To investigate the intraoperative nursing cooperation of in posterior lumbar interbody fusion(PLIF)surgery assisted by orthopedic surgical robot.Methods:From August 2018 to October 2018,3 cases of PLIF surgeries were performed and assisted by the XGK-6508A intelligent minimally invasive orthopedic surgery system in Sun Yat-sen Memorial Hospital,Sun Yat-sen University.During the surgery,the pedicle screw placements were performed with the assistance of orthopedic surgical robot by posterior approach,while the pedicle screw and rod fixation,vertebral canal decompression and the intervertebral cage insertion were performed manually.Besides,4 cases of PLIF surgeries without the assistance of orthopedic surgical robots were also reviewed.Operation room nurses completed the preoperative surgical simulation exercises,patient preparations and inspection on surgical room,equipment and routine items,as well as intraoperative equipment placement,docking,management and application in cooperation with the surgeons.The hospital stays,operation time,intraoperative blood loss,number of screws,total number of exposures before and after the operations,the number of preoperative registered exposures,the number of verified exposures in operation,the number of consumable materials and operation expenses of all patients were observed.Results:The number of screws in the robot group(RG)and the non-robot group(NRG)was 5.00±1.00 Vs 5.00±1.15,the intraoperative blood loss was(216.67±246.64)ml(RG)Vs(262.50±249.58)ml(NRG),the hospital stay time was(17.33±4.51)d(RG)Vs(18.50±6.76)d(NRG).The above data shows no statistical difference between the two groups(P>0.05).The operative time was(285.00±44.44)min(RG)Vs(196.25±85.09)min(NRG),the surgical exposure times were 9.00±3.00(RG)Vs 4.75±0.50(NRG)and the surgical expenses were¥15634.17±7218.14(RG)Vs¥12130.50±1478.62(NRG).These differences between the two groups were statistically significant(P<0.05).Conclusion:Robot-assisted surgery is of great potential.Besides knowing the

关 键 词：手术机器人 机器人辅助骨科手术 后侧入路腰椎间融合术 手术室护理 

分 类 号：R684[医药卫生—骨科学] R473[医药卫生—外科学]