改良单一体位在机器人辅助腹腔镜下肾输尿管及膀胱袖状切除术中的应用效果  

Application effect of modified single position in robot-assisted laparoscopic nephroureterectomy and bladder cuff excision

作　　者：杨芬玲 别逢桂[1] 周帅 黄绿香[1] 林威 陈文龙 李梓豪 李冠升 黄春景 吴展华[1] YANG Fenling;BIE Fenggui;ZHOU Shuai;HUANG Lüxiang;LIN Wei;CHEN Wenlong;LI Zihao;LI Guansheng;HUANG Chunjing;WU Zhanhua(Operating Room,Guangdong Provincial People’s Hospital/Guangdong Academy of Medical Sciences,Guangdong 510080,China)

机构地区：[1]广东省人民医院·广东省医学科学院手术室,广东广州510080

出　　处：《机器人外科学杂志（中英文）》2023年第1期25-33,共9页Chinese Journal of Robotic Surgery

基　　金：广东省医学科学技术研究基金项目(A2022529)。

摘　　要：目的:探讨改良单一体位在机器人辅助腹腔镜下肾输尿管及膀胱袖状切除术中的应用效果。方法:选取2020年6月—2022年5月于广东省人民医院行达芬奇机器人肾输尿管及膀胱袖状切除术的31例患者作为研究对象,其中2020年6月—2021年9月的21例患者采取传统体位(传统体位组);2021年10月—2022年5月的10例患者采取改良单一体位(改良单一体位组),比较两组患者在手术体位摆放时间、体位摆放前后生命体征变化、医疗器械相关压力性损伤、机械臂故障、手术时间、术中出血量、静脉输液不畅率及医护人员满意度等指标的差异。结果:改良单一体位组患者手术体位摆放时间和手术时间方面显著短于传统体位组(P<0.05),采用单一改良体位的医护满意度高于传统体位(P<0.05),其余指标比较差异无统计学意义(P>0.05)。结论:达芬奇机器人辅助腹腔镜下肾输尿管及膀胱袖状切除术使用改良单一体位可有效缩短手术体位摆放的时间和手术时间,提高手术效率,同时可极大改善手术医护人员的满意度,值得临床推广。Objective:To investigate the efficacy of modified single position in robot-assisted laparoscopic nephroureterectomy and bladder cuff excision for upper tract urothelial cancer(UTUC).Methods:31 patients with UTUC who underwent robot-assisted nephroureterectomy and bladder cuff excision in Guangdong Provincial People’s Hospital from June 2020 to May 2022 were selected into this study.Among which,21 patients received the surgery under traditional position from June 2020 to September 2021 were divided into the traditional position group,and 10 patients under the modified single position from October 2021 to May 2022 were divided into the modified single position group.The positioning time,vital signs before and after positioning,medical device-related pressure injuries,robot arm fault,operative time,intraoperative blood loss,intravenous infusion failure rate and medical staff satisfaction rate of the two groups were compared and analyzed.Results:The positioning time and operative time in the modified single position group were significantly shorter than those in the traditional position group(P<0.05),while there was no significant difference in other indicators(P>0.05).Conclusion:Da Vinci robot-assisted laparoscopic nephroureterectomy and bladder cuff excision for UTUC with the modified single position could effectively shorten the positioning time and operative time,greatly improve the efficiency of operation and the satisfaction of medical staff,which is worthy of clinical application.

关 键 词：机器人辅助手术 腹腔镜手术 上尿路尿路上皮癌 肾输尿管切除 膀胱袖状切除 手术体位 

分 类 号：R615[医药卫生—外科学] R693[医药卫生—临床医学]