加速康复外科理念在机器人辅助腹腔镜下根治性前列腺切除术护理中的应用  

Application of the concept of enhanced recovery after surgery in robot-assisted laparoscopic radical prostatectomy

作　　者：喻晓芬[1] 何茫茫 YU Xiaofen;HE Mangmang(Department of Operating Room,Zhejiang Provincial People's Hospital/People’s Hospital of Hangzhou Medical College,Hangzhou 310014,China)

机构地区：[1]浙江省人民医院·杭州医学院附属人民医院手术室,浙江杭州310014

出　　处：《机器人外科学杂志(中英文)》2025年第1期134-140,共7页Chinese Journal of Robotic Surgery

基　　金：浙江省医药卫生科技计划项目(2022KY065)。

摘　　要：目的:探讨基于加速康复外科(ERAS)理念的手术护理在机器人辅助腹腔镜下根治性前列腺切除术中的应用效果。方法:选取2021年6月—2022年6月浙江省人民医院实施机器人辅助腹腔镜下根治性前列腺切除术的216例患者为研究对象,其中2021年6月—2021年12月收治的110例患者采用传统护理模式(对照组),2022年1月—2022年6月收治的106例患者采用基于ERAS理念护理模式(干预组)。比较两组访视前、麻醉诱导前焦虑和信息需求评分,手术时间、术中出血量、术中低体温发生率、麻醉诱导前及手术结束离室前的下肢静脉血流情况、首次下床时间、首次肛门排气时间、首次排便时间、住院时间、术后8 h、24 h、48 h疼痛数字评分表(NRS)评分及术后并发症发生率。结果:干预组麻醉诱导前焦虑和信息需求低于对照组(P<0.001);术中低体温发生率低于对照组(P=0.020);下肢静脉血流情况优于对照组(P=0.031)。干预组首次下床时间、首次肛门排气时间、首次排便时间、住院时间及术后8h、24h、48hNRS评分、术后并发症发生率均低于对照组,差异均有统计学意义(P<0.05)。结论:基于ERAS理念的手术护理模式可减轻机器人辅助腹腔镜下根治性前列腺切除术中患者术前焦虑与信息需求程度,减少术中低体温、下肢静脉血流淤滞及术后并发症发生率,缓解术后疼痛,促进患者术后快速康复,值得临床推广。Objective:To explore the effect of surgical nursing based on the concept of enhanced recovery after surgery(ERAS)in robot-assisted laparoscopic radical prostatectomy(RALP).Methods:216 patients who underwent robot-assisted laparoscopic radical prostatectomy in Zhejiang Provincial People’s Hospital from June 2021 to June 2022 were selected as the research objects.In order of admission,the first 110 patients were selected into the control group(traditional nursing model),and the rest 106 patients into the intervention group(concept of ERAS mode).The two groups were compared in terms of anxiety levels and the need for information before the visit and the anesthesia induction,operative time,intraoperative bleeding,incidence of intraoperative hypothermia,venous blood flow to the lower extremities before anesthesia induction and after surgery,first time to ambulation and defecation,length of hospital stay,numeric rating scale(NRS)scores of pain at 8 h,24 h,and 48 h after surgery,and incidence of postoperative complications.Results:Compared to the control group,patients in the intervention group experienced lower levels of anxiety and the need for information(P<0.001),lower incidence of hypothermia(P=0.020),improved venous blood flow in the lower extremities(P=0.031),and shorter length of hospital stay,anal exhaust defecation,and ambulation(P<0.05).Additionally,after surgery,the NRS scores at 8,24,and 48 hours,as well as the incidence of complications of the intervention group were also lower than those in the control group(P<0.05).Conclusion:For patients undergoing robot-assisted laparoscopic radical prostatectomy,the surgical nursing model based on the concept of ERAS can effectively reduce preoperative anxiety and surgical information demands,lower intraoperative hypothermia and limb venous stasis in the lower extremities,reduce the incidence of postoperative complications,alleviate postoperative pain,and accelerate recovery after surgery.As a result,it merits clinical promotion.

关 键 词：加速康复外科 手术室护理 前列腺癌 机器人辅助腹腔镜手术 根治性前列腺切除术 

分 类 号：R473.73[医药卫生—护理学]