术后持续有创的动脉压监测及专职护理在腹腔镜大体积嗜铬细胞瘤切除术后患者中的应用

Effect of continuous invasive arterial pressure monitoring and full-time nursing versus routine nursing on patients with large pheomocytoma after surgery

目的:探讨持续有创的动脉压监测及专职护理在腹腔镜大体积嗜铬细胞瘤术后患者中应用的效果。方法:我们回顾性分析了于我院2007年01月01日至2017年12月31日期间的128例肿瘤直径大于6厘米的行腹腔镜嗜铬细胞瘤手术患者的围手术期资料,分为持续有创的动脉压监测及专职护理组(continuous invasive arterial pressure monitoring and full-time nursing,CIAPM)和常规护理组(routine nursing,RN),比较两组术前、术中和术后的临床资料。结果:持续有创的动脉压监测及专职护理组的术后低血压及心血管并发症发生率低于常规护理组(4.7%vs 23.4%,P=0.002和14.1%vs 37.5%,P=0.002)。其肠道恢复时间也更快(1.9天vs 2.3天,P<0.001)。结论:我们的研究表明持续有创的动脉压监测及专职护理能够降低腹腔镜大体积嗜铬细胞瘤患者术后的低血压及心血管并发症的风险,促进患者肠道功能的快速恢复。

Objective:To explore the effect of continuous and invasive arterial pressure monitoring and full-time nursing in patients with large pheochromocytoma after laparoscopic surgery.Methods:We retrospectively analyzed the perioperative data of 128 patients who underwent laparoscopic pheochromocytoma surgery with tumor diameter greater than 6 cm from January 1,2007 to December 31,2017 in our hospital.They were divided into continuous invasive arterial pressure monitoring and full-time nursing group(CIAPM)group and routine nursing group(RN group).The perioperative data were collected and compared between the two groups.Results:The incidence of postoperative prolonged hypotension and cardiovascular complications in continuous invasive arterial pressure monitoring and full-time nursing group was lower than that in routine nursing group(4.7%vs 23.4%,P=0.002 and 14.1%vs 37.5%,P=0.002).The intestinal recovery time was also faster(1.9 days vs 2.3 days,P<0.001).Conclusion:Our study shows that continuous invasive arterial pressure monitoring and full-time nursing can reduce the risk of postoperative prolonged hypotension and cardiovascular complications after laparoscopic large pheochromocytoma surgery,and promote the rapid recovery of intestinal function.