达芬奇机器人胰十二指肠手术患者围手术期的管理

目的:探讨达芬奇机器人胰十二指肠手术患者围手术期的管理要点。方法:对46例采用达芬奇机器人手术系统行胰十二指肠手术的患者的围手术期管理进行回顾分析。围手术期管理内容包括:手术患者的选择,术前心理护理,术前准备,术中正确摆放体位及选择气腹压力,术后监测生命体征、做好并发症的预防及护理等。结果:46例患者恢复良好,平均住院23.8d,无病死患者;13例患者出现并发症,其中胰漏10例、胆漏2例、出血1例,予以对症治疗和相应的护理后痊愈。结论:掌握达芬奇机器人胰十二指肠手术技术的同时,做好围手术期管理工作也是促进患者康复和减少患者术后并发症、降低病死率的重要措施。

Perioperative Management of Pancreaticoduodenectomy by Using Da Vinci Robotic Surgical System

Objective：To discuss the key points of perioperative management in pancreaticoduodenectomy by using Da Vinci ro- botic surgical system. Methods：The perioperative management of 46 patients who received pancreaticoduodenectomy by using Da Vinci robotic surgical system at Ruijin Hospital,Shanghai Jiaotong University School of Medicine were retrospectively sum- marized and analyzed. The perioperative management included selection of appropriate patients, preoperative psychological care, preoperative preparation, right body-position and right intraabdominal pressure, postoperative monitoring of vital signs, and prevention and nursing of the complications. Results： The mean postoperative hospital-stay of these patients were 23.8 days, with no death. Complications were found in 13 patients,including 10 pancreatic fistula,2 biliary fistula and 1 hemorrhage. All of them recovered after receiving relevant treatments and nursing. Conclusions： To promote the postoperative recovery and reduce the occurence rate of the postoperative complications and mortality, the perioperative management is as important as mastering advanced surgical techniques.