术中体位护理联合手术室低体温防护对机器人辅助根治性膀胱切除原位回肠新膀胱术患者舒适度及术后并发症的效果比较  

Effect of intraoperative positioning nursing combined with hypothermia protection in operating room on the comfort and postoperative complications of patients undergoing robot-assisted laparoscopic radical cystectomy and orthotopic ileal neobladder

作　　者：袁蓓 边东梅 闫沛 杜白茹 YUAN Bei;BIAN Dongmei;YAN Pei;DU Bairu(Surgical Operating Room,the First Affiliated Hospital of Air Force Military Medical University,Xi’an 710032,China)

机构地区：[1]空军军医大学第一附属医院外科手术室,陕西西安710032

出　　处：《机器人外科学杂志（中英文）》2024年第2期206-212,共7页Chinese Journal of Robotic Surgery

基　　金：陕西省重点研发计划项目(S2022-YF-025)。

摘　　要：目的:分析术中体位护理联合手术室低体温防护护理对机器人辅助根治性膀胱切除原位回肠新膀胱术(RARC-OIN)患者舒适度及术后并发症的改善效果。方法:选取行RARC-OIN且完成1年随访的患者进行回顾性研究。选择2021年6月—2022年6月接受常规护理的60例患者作为对照组,选择2022年7月—2023年7月接受术中体位护理联合手术室低体温防护护理的60例患者作为观察组,两组均干预至患者出院。比较两组患者围手术期指标、不同时点肛温、心率(HR)、平均动脉压(MAP)、术后并发症及复发情况。结果:观察组手术时间、术后住院时间短于对照组,术中出血量低于对照组;患者术中肛温相较术前逐步降低,于术毕升高,观察组各时点肛温高于对照组;术中1 h、3 h时HR、MAP相较术前逐步升高,并于术中6 h、术毕时逐步下降,观察组各时点HR、MAP低于对照组;观察组舒适率及舒适度评分均高于对照组;两组并发症发生率及复发率比较,差异无统计学意义。结论:术中体位护理联合手术室低体温防护护理能够有效稳定RARC-OIN患者术中生命体征,保持体温稳定,提升舒适度,缩短住院时间,促进术后康复。Objective:To analyze the effect of intraoperative body position nursing combined with hypothermia protection in the operating room on the comfort and postoperative complications of patients undergoing Robot-assisted Radical Cystectomy with Orthotopic Ileal Neobladder(RARC-OIN).Methods:Patients who underwent RARC-OIN and completed 1-year follow-up were selected for retrospective study.60 patients who were received routine nursing from June 2021 to June 2022 were selected as the control group,and 60 patients received intraoperative positioning nursing combined with hypothermia protection in operating room from July 2022 to July 2023 were selected as the observation group.Both groups were intervened until the patients were discharged from hospital.The perioperative indexes,anal temperature,heart rate(HR),mean arterial pressure(MAP)at different time points,postoperative complications and recurrence rate were compared between the two groups.Results:The operative time and postoperative hospitalization stay of the observation group were shorter than those of the control group,and the intraoperative blood loss was lower than that of the control group.The anal temperature of patients decreased gradually during the operation compared with that before the operation,and increased at the end of the operation.The anal temperature of the observation group was higher than that of the control group at each time.HR and MAP at 1 h and 3 h during operation were gradually increased compared with those before operation,and gradually decreased at 6 h during operation and the end of operation.HR and MAP in the observation group were lower than those in the control group at each time point.The comfort rate and comfort score of the observation group were higher than those of the control group.There was no difference in the incidence of complications and recurrence rate between the two groups.Conclusion:Intraoperative positioning nursing combined with hypothermia protection in the operating room can effectively stabilize the vital signs of

关 键 词：膀胱癌 机器人辅助手术 根治性膀胱切除术 原位回肠新膀胱术 舒适度 并发症 

分 类 号：R472.3[医药卫生—护理学] R737.14[医药卫生—临床医学]