泌尿系机器人辅助腹腔镜手术胃管的置入与拔除时机研究

Study on the timing of the placement and removal of gastric tube in robot-assisted laparoscopic surgery of urology

目的探究泌尿系机器人辅助腹腔镜手术胃管的置入与拔除时机。方法选取我院2015年1月-2016年12月收治的泌尿系机器人辅助腹腔镜手术的患者646例,按随机数字表法分为两组,各323例。对照组于麻醉前留置胃管,并在肛门排气后拔除;观察组于麻醉后留置胃管,并在术后即刻拔除。对比两组手术前后患者恶心和呕吐发生率、术后排气时间及下床活动时间。结果观察组术前恶心和呕吐发生率与对照组相比差异无统计学意义(P>0.05),观察组术后恶心和呕吐发生率低于对照组,差异有统计学意义(P<0.05);观察组术后≤24 h、>24～48 h排气患者多于对照组,术后>48～72 h、≥72 h排气患者少于对照组,差异有统计学意义(P<0.05);观察组术后≤24 h、>24～48 h及>48～72 h排气患者多于对照组,≥72 h排气患者少于对照组,差异有统计学意义(P<0.05)。结论术后即刻拔除胃管可有效缩短泌尿系机器人腹腔镜手术患者肛门排气时间,并促进其早期下床活动,值得临床推广。

Objective To explore the timing of placement and removal of gastric tube in robot-assisted laparoscopic surgery of urology.Methods From January 2016 to December 2016,646 patients undergoing robotic assisted laparoscopic surgery were selected and divided into 2 groups according to the random number table method.323 cases were performed,including 317 cases of radical prostatectomy and 329 cases of renal tumor surgery.The incidence of nausea and vomiting before and after surgery,postoperative venting time,and time of ambulation were compared between the two groups.Results The incidence of nausea and vomiting before operation in the observation group was not significantly different from that in the control group(P>0.05).The incidence of nausea and vomiting after operation in the observation group was much lower than that in the control group(P<0.05).The number of patients with exhaust less than 24 hours and 24~48 hours after operation in the observation group was much higher than that of the control group,and the number of patients with exhaust less than 48~72 hours and more than 72 hour in observation group was less than that of the control group(P<0.05).The number of patients with exhaust 24~48 hours,48~72 hours and less than 72 hours after operation in the observation group was higher than that in the control group.There was significant difference between groups(P<0.05).Conclusion The removal of gastric tube within 24 hours after operation can effectively shorten the anus exhaust time of patients undergoing robot-assisted laparoscopic surgery and promote their early ambulation,which is worthy of clinical promotion.