达芬奇机器人辅助下肝癌根治术的临床疗效及围手术期护理路径的构建

Efficacy of Da Vinci robot-assisted liver cancer radical resection and construction of postoperative nursing pathway

目的:探究达芬奇机器人辅助下肝癌根治术的临床疗效以及护理路径在患者围手术期的应用效果。方法:选取2020年1月—2022年12月在四川省人民医院和成都市第三人民医院接受达芬奇机器人辅助下肝癌根治术的80例患者,采用随机数字表法将其分为研究组和对照组,各40例。对照组给予常规护理干预,研究组给予临床护理路径(CNP)。对比两组临床疗效、肝功能指标、生活质量评分、心理状态评分及住院指标。结果:所有手术均顺利完成,仅有1例胆漏,3例肝断面积液,经保守治疗后相关患者症状均消失;随访6~36个月所有患者均无复发或死亡;比较两组术后肝功能指标、各项生活质量评分、心理状态评分,差异具有统计学意义(P>0.05);出院前,两组肝功能指标和心理状态评分均明显降低,两组各项生活质量评分均明显升高,且研究组明显优于对照组,差异具有统计学意义(P<0.05);研究组卧床时间、住院时间、住院费用明显低于对照组,差异具有统计学意义(P<0.05)。结论:达芬奇机器人辅助下肝癌根治术能够取得良好的手术效果。同时与传统护理干预措施相比,临床护理路径构建的标准化护理流程能够改善患者肝功能、提高生活质量、调节不良情绪,具有较高的临床应用和推广价值。

Objective:To explore the clinical efficacy of Da Vinci robot-assisted liver cancer radical resection and nursing pathway during perioperative period.Methods:A total of 80 patients who received robot-assisted liver cancer radical resection in Sichuan People’s Hospital and the Third People’s Hospital of Chengdu from January 2020 to December 2022 were selected and divided into the study group(n=40)and the control group(n=40)by random number table method.The control group was given routine nursing intervention,and the study group was given clinical nursing pathway.The clinical efficacy,liver function indexes,quality of life scores,psychological scores and hospitalization indexes were compared between the two groups.Results:All the operations were successfully completed,only 1 case of bile leakage,3 cases of liver sectional effusion.After conservative treatment,symptoms of the relevant patients disappeared,and all patients were followed up for 6-36 months without recurrence or death.The liver function indexes,quality of life(QoL)scores and psychological scores were compared between the two groups,and the differences were statistically significant(P>0.05).Before discharge,liver function indexes and psychological scores of both groups were significantly decreased,and QoL scores of both groups were significantly increased,and the study group was significantly better than the control group,the difference was statistically significant(P<0.05).The bed time,hospital stay and hospital costs of the study group were significantly lower than those of the control group,and the differences were statistically significant(P<0.05).Conclusion:Da Vinci robot-assisted liver cancer radical resection could achieve good surgical results.Compared with traditional nursing interventions,clinical nursing pathways could improve patients’liver function,improve QoL,regulate negative emotions,and have better clinical application and promotion value.