达芬奇机器人与胸腔镜在肺叶切除术中的围手术期护理对比

Comparison between Nursing of Da Vinci Robot System and Video-assisted Thoracoscopy in Pulmonary Lobectomy

目的对比达芬奇机器人与胸腔镜在肺叶切除术中的围术期护理及疗效。方法对2014年1月—2015年4月上海胸科医院168例行肺叶切除术患者的临床资料进行回顾性分析,其中达芬奇机器人和胸腔镜手术系统组各84例。结果与胸腔镜组相比,机器人组术中出血量少、手术时间长、术后72小时引流量少、术后置管天数少、术后住院天数少、手术费用高。此外,机器人手术在术前宣教、术中保温、无菌管理、设备前期调试和准备及故障处理等方面都有更高的要求。结论达芬奇机器人较胸腔镜在肺叶切除手术中的安全性和术后恢复更优,但手术总时长和费用显著增加。

Objective To compare the curative effect and nursing cooperation between Da Vinci Robot system（ ROB） and video-assisted thoracoscopy（ VATS） in pulmonary lobectomy. Methods A retrospective analysis was conducted to analyze the clinical data of 168 cases who undergoing pulmonary lobectomy at Shanghai Chest Hospital between January 2014 and April 2015. Da Vinci robot and video-assisted thoracoscopic surgery accounted for 84 cases each. Results Compared with VATS group,the ROB group had less intraoperative blood loss,longer surgery duration,less postoperative drainage amount within 72 hours after surgery,shorter period of bearing drainage tubes,shorter hospital stays and higher hospitalization expense. In addition,ROB made greater demands on preoperative instruction and education,intraoperative insulation,aseptic management,preoperative equipment adjustment and preparation,ability of fault handling for nursing cooperation. Conclusion The safety and postoperative recovery of ROB are better than that of VATS in lobectomy,but the surgery duration is longer and expense is higher in ROB lobectomy.