达芬奇机器人手术联合康复训练和精细化管理干预对直肠癌患者胃肠功能的影响

Effect of Da Vinci robotic surgery combined with rehabilitation training and refined management intervention on gastrointestinal function of rectal cancer patients

目的探讨达芬奇机器人手术联合康复训练和精细化管理干预对直肠癌患者胃肠功能的影响。方法依据手术方法的不同将112例直肠癌根治术患者分为对照组和观察组,对照组患者给予开腹手术,观察组患者给予达芬奇机器人辅助手术,两组患者术后均给予康复训练和精细化管理干预。比较两组患者手术相关指标、疼痛程度[数字分级评分法(NRS)]、胃动素水平及并发症发生情况。结果观察组患者切口长度短于对照组,肠鸣音恢复时间、首次排气时间、首次排便时间、尿管拔除时间、饮食恢复时间、住院时间均短于对照组,手术时间长于对照组,差异均有统计学意义(P﹤0.05)。术后12、24、48 h,两组患者的NRS评分均低于本组术后6 h,且观察组患者NRS评分均低于对照组,差异均有统计学意义(P﹤0.05)。术后两组患者的血清胃动素水平均先降低后逐渐恢复至术前水平,观察组患者于术后3天恢复至术前水平,对照组患者于术后7天恢复至术前水平,且术后1、3、7天观察组患者的血清胃动素水平均高于对照组,差异均有统计学意义(P﹤0.05)。术后,观察组患者并发症总发生率为5.36%,与对照组患者的10.71%比较,差异无统计学意义(P﹥0.05)。结论达芬奇机器人手术联合术后康复训练和精细化管理干预可促进直肠癌患者胃肠功能的恢复,减轻疼痛程度,缩短病程。

Objective To investigate the effect of Da Vinci robot-assisted surgery combined with rehabilitation training and refined management intervention on gastrointestinal function in patients with rectal cancer. Method A total of 112 patients with radical resection of rectal cancer were divided into control group and observation group according to different surgical methods, 56 cases in each group. The control group were given laparotomy, the observation group were given Da Vinci robot-assisted surgery, and both groups were given postoperative rehabilitation training combined with refined management intervention. The operation-related indicators, pain level [numerical rating scale(NRS)], motilin level,and complications were compared between the two groups. Result The length of the incision in the observation group was shorter than that in the control group, and the recovery time of bowel sounds, the time of the first flatus, the time of the first defecation, the time of removal of the urinary catheter, the time of diet recovery, and the hospitalization time were all shorter than those of the control group, and the operation time was longer than that in the control group, and the differences were statistically significant(P<0.05). At 12, 24, and 48 hours after the operation, the NRS scores of the two groups were lower than those at 6 hours after the operation, and the NRS scores of the observation group were lower than those of the control group, and the differences were statistically significant(P<0.05). After the operation, the serum motilin levels of the two groups of patients first decreased and then gradually returned to the preoperative level, the observation group recovered to the preoperative level after 3 days, and the control group recovered to the preoperative level at 7days after the operation, and at 1, 3, and 7 days after the operation, the serum motilin levels in the observation group were higher than those in the control group, the differences were statistically significant(P<0.05). After the operation, the total incidence of complications in the observation group was 5.36%, compared with 10.71% in the control group, and the difference was not statistically significant(P>0.05). Conclusion Da Vinci robot combined with rehabilitation training and refined management intervention can promote the recovery of gastrointestinal function of rectal cancer patients, reduce pain and shorten the course of disease.