达芬奇机器人辅助下肾细胞癌手术术中用血情况的观察  

Observation of red blood cell transfusion in Da Vinci robot-assisted operation of patients with renal cell carcinoma

作　　者：宋金鸽 李鸿威 杨楠 宋歌 张晓卿[1] Song Jinge;Li Hongwei;Yang Nan;Song Ge;Zhang Xiaoqing(Department of Transfusion,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院输血科,100191 [2]首都医科大学附属北京友谊医院呼吸科

出　　处：《北京医学》2022年第6期537-540,共4页Beijing Medical Journal

摘　　要：目的探讨达芬奇机器人对肾细胞癌手术患者用血的影响。方法选取2020年4月至2021年4月北京大学第三医院确诊为肾细胞癌且行根治性肾切除术或部分肾切除术的患者221例,其中28例行达芬奇机器人辅助的根治性肾切除术(robot-assisted radical nephrectomy,RRN),64例行腹腔镜下根治性肾切除术(laparoscopic radical nephrectomy,LRN);53例行机器人辅助的部分肾切除术(robot-assisted partial nephrectomy,RPN),76例行腹腔镜下部分肾切除术(laparoscopic partial nephrectomy,LPN)。分别比较各组的术中出血量、术中用血率、手术时间、术后Hb水平和住院时间。结果RRN组的术中出血量、术中用血率、手术时间和住院时间显著低于LRN组[20(20,150)ml比50(20,500)ml,3.6%比21.9%,128.00(80.00,177.30)min比175.50(143.80,257.80)min,8.50(7.00,11.00)d比11.00(7.00,14.75)d],差异均有统计学意义(P<0.05);RPN组的手术时间和住院时间明显短于LPN组[(117.90±42.18)min比(152.20±47.95)min,6.00(6.00,7.00)d比8.00(7.00,9.80)d],差异均有统计学意义(P<0.05)。结论与传统腹腔镜相比,机器人辅助下的肾癌治疗手术可以缩短手术时间和住院时间,且RRN还具有创伤小、术中出血量少、用血率低和节约血资源的优势。Objective To explore the effect of Da Vinci robot on red blood cell transfusion of patients undergoing renal cell carcinoma surgery.Methods A total of 221 patients diagnosed with renal cell carcinoma and undergoing radical nephrectomy or partial nephrectomy in Peking University Third Hospital from April 2020 to April 2021 were selected.Among them,28 patients underwent Da Vinci robot-assisted radical nephrectomy(RRN),64 patients underwent laparoscopic radical nephrectomy(LRN).Robot-assisted partial nephrectomy(RPN)was performed in 53 cases,laparoscopic partial nephrectomy(LPN)was performed in 76 cases.Intraoperative blood loss,intraoperative transfusion rate,operative time,postoperative Hb level,total cost of hospitalization and hospitalization time were compared among all groups.Results The RRN group had less intraoperative blood loss,lower transfusion rate,shorter operative time and hospitalization time when compared with LRN group[20(20,150)ml vs.50(20,500)ml,3.6%vs.21.9%,128.00(80.00,177.30)min vs.175.50(143.80,257.80)min,8.50(7.00,11.00)d vs.11.00(7.00,14.75)d],and the differences were statistically significant(P<0.05).The operative time and hospitalization time in RPN group were shorter than those in LPN group[(117.90±42.18)min vs.(152.20±47.95)min,6.00(6.00,7.00)d vs.8.00(7.00,9.80)d],and the differences were statistically significant(P<0.05).Conclusions Compared with traditional laparoscopy,robot-assisted renal cancer treatment can shorten the operation time and hospitalization time.RRN also has the advantages of less trauma,less intraoperative blood loss,lower transfusion rate and saving blood resources.

关 键 词：达芬奇机器人 腹腔镜手术 根治性肾切除术 部分肾切除术 术中输血 

分 类 号：R737.11[医药卫生—肿瘤]