机器人辅助腹腔镜前列腺癌根治术后胃管拔除时机的探讨

目的 探讨机器人辅助腹腔镜前列腺癌根治性切除术后胃管拔除的最佳时机.方法 选择2012年7月～2013年6月解放军总医院收治的行机器人辅助腹腔镜前列腺癌根治术的患者110例为研究对象,按病区不同分为实验组（n=52）和对照组（n=58）.实验组术后24h内拔除胃管,对照组术后肛门排气后拔除胃管,比较两组患者术后住院时间、肛门排气时间及下床活动时间.结果 ①实验组术后住院天数（6.67±3.21）d]少于对照组（8.90±6.21）d],差异有高度统计学意义（P＜0.01）;②实验组术后＜24h、48～＜ 72 h、≥96 h肛门排气患者所占比例分别为1.92％、42.32％、1.92％,与对照组（0.00％、39.66％、6.89％）比较,差异均无统计学意义（P＞0.05）;实验组患者术后24～＜ 48 h、72～＜ 96 h肛门排气时间所占比例（46.15％、7.69％）高于对照组（29.31％、24.14％）,差异有统计学意义（P＜0.05）.③实验组术后＜24h、24～＜ 48 h、48～＜ 72 h、72～＜ 96 h、≥96 h下床活动患者所占比例分别为19.23％、42.31％、36.54％、1.92％、0.00％,与对照组（3.46％、27.58％、22.41％、31.03％、15.52％）比较,差异均有统计学意义（均P＜ 0.05）.结论 前列腺癌行机器人辅助腹腔镜根治性切除术患者尽早拔除胃管,有利于促进患者康复,提高患者舒适度,减少患者住院期间费用,提高护理人员工作效率.

Discussion of the optimal time to remove gastric tube of patients undergoing robot-assisted laparoscopic redical prostatectomy

Objective To investigate the optimal time to remove the gastric tube of patients undergoing robot-assisted laparoscopic redical prostatectomy.Methods 110 patients undergoing robot-assisted laparoscopic prostatectomy in the General Hospital of PLA from July 2012 to June 2013 were selected as study objects,and they were divided into experimental group （n=52） and control group （n=58） according to different department,the experimental group was removed gastric tube within postoperative 24 hours,the control group was removed gastric tube after anus exhaust,length of hospital after operation,postoperative anal exhaust time,ambulation time of two groups were compared.Results ①The length of hospital after operation of the experimental group （6.67±3.21） d] was shorter than that of the control group （8.90±6.21） d],the difference was high statistically significant （P ＜ 0.01）.② The proportion of postoperative anal exhaust time ＜ 24 hours,48-＜ 72 hours,≥ 96 hours of the experimental group were 1.92％,42.32％,1.92％ respectively,and the control group were 0.00％,39.66％,6.89％ respectively,there were no statistically significant differences （P ＞ 0.05）; the proportion of postoperative anal exhaust time in 24-＜ 48 hours and 72-＜ 96 hours after operation of the experimental group （46.15％,7.69％） were higher than those of the control group （29.31％,24.14％）,the differences were statistically significant （P ＜ 0.05）.③ The proportion of ambulation time within 24 hours,24-＜ 48 hours,48-＜ 72 hours,72-＜ 96 hours,≥ 96 hours after operation in experiment group were 19.23％,42.31％,36.54％,1.92％,0.00％ respectively,and the control group were 3.46％,27.58％,22.41％,31.03％,15.52％ respectively,the differences were statistically significant （all P ＜ 0.05）.Conclusion The patients undergone robot-assisted laparoscopic radical prostatectomy removed gastric tube as soon as possible,this manner can promote the postoperative recover,improve the comfortable degree of patients,thus to reduce the cost of hospitalization and improve the nursing work efficiency.