合理管理在腹腔镜下根治性膀胱全切Bricker术围手术期的应用效果  

Application effect of rational management in perioperative period of laparoscopic radical cystectomy with Bricker procedure

作　　者：刘方[1] 卓林 王俊 LIU Fang;ZHUO Lin;WANG Jun(Department of Urology,Pingxiang People's Hospital,Jiangxi Province,Pingxiang 337000,China;Department of Urology,Pingxiang NO.2 People's Hospital,Jiangxi Province,Pingxiang 337000,China)

机构地区：[1]江西省萍乡市人民医院泌尿外科,江西萍乡337000 [2]江西省萍乡市第二人民医院泌尿外科,江西萍乡337000

出　　处：《中国当代医药》2023年第16期104-108,共5页China Modern Medicine

基　　金：江西省萍乡市科技计划项目(培育类)(2020PY 083)。

摘　　要：目的探讨合理管理在腹腔镜下根治性膀胱全切Bricker术围手术期的应用效果。方法回顾性选取2016年10月至2022年9月萍乡市人民医院及萍乡市第二人民医院收治的60例膀胱癌全切患者作为研究对象,按照围手术期管理方式的不同,将其分为A组(n=32,常规管理)和B组(n=28,常规+合理管理),比较两组患者的并发症发生率、手术时间、术中出血量、早期下床活动时间、住院天数、术后费用、术后视觉模拟评分(VAS)和生活质量评分。结果B组术后并发症总发生率低于A组,差异有统计学意义(P<0.05)。B组手术时间、早期下床活动时间、住院天数均短于A组,术中出血量、术后费用少于A组,差异有统计学意义(P<0.05)。两组患者VAS评分组间比较、时间比较以及交互作用比较,差异均有统计学意义(P<0.05)。B组术后48 h的VAS评分低于本组术后12 h,差异有统计学意义(P<0.05);B组术后12、24和48 h的VAS评分均低于A组,差异有统计学意义(P<0.05);术前,两组患者的生理机能、生理职能、精力、一般健康状况、社会功能、情感职能、精神健康评分和总分比较,差异无统计学意义(P>0.05);术后,两组患者的生理机能、生理职能、精力、一般健康状况、社会功能、情感职能、精神健康评分和总分高于本组术前,且B组分数高于A组,差异有统计学意义(P<0.05)。结论对腹腔镜下根治性膀胱全切Bricker术围手术期的患者进行合理管理,能够有效降低并发症发生率,缩短手术时间、早期下床活动时间和住院天数,减少术中出血量和手术费用,同时能够减轻患者疼痛,提高其生活质量。Objective To explore the application effect of rational management in the perioperative period of laparoscopic radical cystectomy with Bricker procedure.Methods A retrospective analysis of 60 patients with bladder cancer who underwent total cystectomy in Pingxiang People's Hospital and Pingxiang NO.2 People's Hospital from October 2016 to September 2022 were selected as research objects.According to different perioperative management methods,they were divided into group A(n=32,routine management)and group B(n=28,routine+rational management).The incidence of complications,operation time,intraoperative blood loss,early ambulation time,hospital stay,postoperative cost,postoperative visual analogue scale(VAS)and quality of life score were compared between the two groups.Results The incidence of postoperative complications in group B was lower than that in group A,and the difference was statistically significant(P<0.05).The operation time,early ambulation time and hospital stay in group B were shorter than those in group A,the intraoperative blood loss and postoperative cost were less than those in group A,and the differences were statistically significant(P<0.05).There were statistically significant differences in VAS scores between two groups of patients,including comparisons between groups,time points,and interactions(P<0.05).The VAS score at 48 h after surgery in group B was lower than that at 12 h,with statistically significant difference(P<0.05).The VAS scores of group B at 12,24,and 48 h after surgery were lower than those of group A,with statistically significant differences(P<0.05).Before surgery,there were no statistically significant differences in the physiological function,physiological function,energy,general health status,social function,emotional function,mental health score,and total score between the two groups(P>0.05).After surgery,the physiological function,physiological function,energy,general health status,social function,emotional function,mental health score and total score of the two groups of

关 键 词：根治性膀胱全切Bricker术 并发症防治 临床应用 围手术期 合理管理 

分 类 号：R473.6[医药卫生—护理学]