11例胰腺癌患者3D腹腔镜胰十二指肠切除合并血管重建术的护理配合

Nursing Cooperation in Laparoscopic Pancreaticoduodenectomy Combined with Vascular Reconstruction: A 11-case Study

目的总结我院11例胰腺癌患者行3D腹腔镜胰十二指肠切除合并血管重建术的护理配合经验。方法2019年1月—2022年4月我院对11例胰腺癌患者在气管内插管全身麻醉下行3D腹腔镜胰十二指肠切除合并血管重建术。护理配合要点包括:肿瘤侵犯血管的长度测量、切除、重建及评估的精准护理;下肢深静脉血栓的防范。结果本组9例在全腹腔镜下完成胰十二指肠切除及血管重建,2例中转开腹完成手术。全部患者术后均复查CT,手术效果满意,围术期无死亡病例、无护理并发症发生。结论腹腔镜胰十二指肠切除合并血管重建手术难度大,做好术前访视及备齐特殊用物;对肿瘤侵犯血管的长度测量、切除、重建及评估需精准护理配合;术中特殊情况应急处理及对下肢深静脉血栓进行预防应对是提高手术效果及患者手术安全的重要保障。

Objective To summarize the nursing experience in laparoscopic pancreaticoduodenectomy(LPD)combined with vascular reconstruction.Methods The data of 11 patients with pancreatic carcinoma with LPD in our hospital from January 2019 to April 2022 were collected.Essential nursing points included precise nursing cooperation for length measurement,resection,reconstruction and evaluation of tumor invaded blood vessels and prevention of deep venous thrombosis of lower limbs.Results Nine patients completed the surgery,while two patients were converted to open surgery.All patients were reexamined with CT after the operation.No death cases and nursing complications were found during perioperative period.Conclusion LPD combined with vascular reconstruction is challenging and preoperative visits and special supplies should be fully prepared.Precise nursing cooperation is needed for the reconstruction and evaluation of tumor invaded blood vessels.Emergency treatment of special cases during operation and prevention of deep venous thrombosis of lower limbs are important to improve the surgical effect and the safety of patients.