经腹入路和经腹膜后入路机器人辅助腹腔镜肾部分切除术的医护配合

Nursing cooperation of robotic assisted laparoscopic partial nephrectomy via transperitoneal approach and retroperitoneal approach

目的总结经腹腔入路和经腹膜后入路机器人辅助腹腔镜肾部分切除术的护理经验。方法回顾性分析我院泌尿外科2016年1月至2020年1月的86例经腹入路和128例经腹膜后入路机器人辅助腹腔镜肾部分切除术的临床资料。评价两种方式体位安置用时、护理潜在风险事件、装机前准备时间、医师满意度等指标。结果两组患者手术均顺利完成,无一例中转开放,两组体位安置用时、护理潜在风险事件发生率、肾热缺血时间、医师满意度比较差异无统计学意义(P>0.05)。但装机前准备时间和手术时间经腹膜后入路较经腹入路缩短,差异有统计学意义(P<0.05)。结论经腹入路和经腹膜后入路机器人肾部分切除在围术期护理上有共性,也各有其护理特点和关注点。术前应充分评估、了解手术方案,根据手术方案针对性进行体位摆设,做好患者安全监护,术中备物齐全、熟练配合,缩短肾动脉阻断时间,才能保证手术效果。

Objective To summarize the nursing cooperation of robot assisted laparoscopic partial nephrectomy via transperitoneal and retroperitoneal approach.Methods The clinical data of 86 cases of robot assisted laparoscopic partial nephrectomy with transperitoneal approach and 128 caseswith retroperitoneal approach were analyzed retrospectively from Jan 2016 to Jan 2020.The time of position placement,nursing potential risk events,preparation time before installation,and doctor satisfaction were recorded in two approaches.Results The operations were completed successfully in both groups,and no patient was transferred to open surgery.There were no statistically significant differences between the two groups in position placement time,incidence of nursing potential risk events,duration of renal hot ischemia,and doctor satisfaction(P>0.05).However,the differences in preparation time before installation and operation time were statistically significant(P<0.05)in two groups.Conclusion Robot-assisted laparoscopic partial nephrectomy via transperitoneal and retroperitoneal approach have their own characteristics and concerns.Preoperative evaluation and understanding of the surgical plan should be carried out.According to the surgical plan,positioning equipment,safety monitoring,complete intraoperative equipment,skilled coordination,and shortening the duration of renal artery occlusion can ensure the surgical effect.