加速康复外科理念在机器人辅助腹腔镜肾盂成形术患儿围手术期中的应用  

Application of the concept of enhanced recovery after surgery in perioperative period of pediatric patients undergoing robotassisted laparoscopic pyeloplasty

作　　者：闫冰 李嵘 陈盼盼 汤医涛 朱云 邵丽侠 YAN Bing;LI Rong;CHEN Panpan;TANG Yitao;ZHU Yun;SHAO Lixia(Department of Nephrology,the First Affiliated Hospital of Air Force Military Medical University,Xi’an 710032,China;Department of Urology,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肾脏内科,陕西西安710032 [2]空军军医大学第一附属医院泌尿外科,陕西西安710032

出　　处：《机器人外科学杂志（中英文）》2024年第4期717-721,共5页Chinese Journal of Robotic Surgery

基　　金：陕西省重点研发计划项目(2017ZDXM-SF-045)。

摘　　要：目的:探究加速康复外科理念在机器人辅助腹腔镜肾盂成形术患儿围手术期中的应用。方法:前瞻性选取2020年1月—2023年1月于空军军医大学第一附属医院收治的104例肾积水患儿为研究对象,采用随机数字表法分为两组,对照组52例采用常规护理,观察组52例采用基于加速康复外科理念的围手术期优化护理。结果:观察组的排气时间、气管插管时间、首次进食时间、首次下床活动时间早于对照组,尿管拔除时间、引流管拔除时间、住院时间均短于对照组;而观察组的护理操作满意度、人文关怀满意度、护患沟通满意度及护理效果满意度评分均高于对照组,差异具有统计学意义(P<0.05),同时,观察组术后并发症发生率低于对照组,行为总依从性高于对照组,差异具有统计学意义(P<0.05)。结论:基于加速康复外科理念的围手术期优化护理在机器人辅助腹腔镜肾盂成形术肾积水患儿中效果显著,可减少术后并发症的发生,促进术后康复。Objective:To explore the application effect of the concept of enhanced recovery after surgery in perioperative period of robot-assisted laparoscopic pyeloplasty for pediatric patients.Methods:A total of 104 children with hydronephrosis admitted to the First Affiliated Hospital of Air Force Military Medical University from January 2020 to January 2023 were prospectively selected as the research objects,and were divided into two groups by random number table method.52 cases in the control group received routine nursing,and 52 cases in the observation group were treated with optimized perioperative nursing based on the concept of enhanced recovery after surgery(ERAS).Results:The exhaust time,endotracheal intubation time,first feeding time and the first postoperative ambulation time in the observation group were earlier than those in the control group,and the time of catheter removal,drainage tube removal and hospitalization time were shorter than those in the control group.The scores of nursing operation satisfaction,humanistic care satisfaction,communication satisfaction and nursing effect satisfaction in the observation group were higher than those in the control group,with statistical significance(P<0.05).Meanwhile,the incidence of postoperative complications in the observation group was lower than that of the control group,and the total compliance rate was higher than that of the control group,with statistical significance(P<0.05).Conclusion:The optimized perioperative nursing measures based on the concept of ERAS has a significant effect on children with hydronephrosis undergoing robotassisted laparoscopic pyeloplasty,which could reduce the occurrence of postoperative complications and promote postoperative rehabilitation.

关 键 词：机器人辅助手术 腹腔镜肾盂成形术 加速康复外科 围手术期 肾积水 

分 类 号：R473.72[医药卫生—护理学]