达芬奇机器人远端胃癌根治术15例护理体会

目的 探讨芬奇机器人远端胃癌根治术的围手术期护理方法.方法 回顾性分析2017年1月我科15例达芬奇机器人远端胃癌根治术患者的手术资料,对本组患者术前进行良好的宣教,做好心理护理,并指导呼吸训练,评估患者营养状况,改善患者营养状况,术后个体化护理,做好并发症的护理.结果 15例患者均顺利完成机器人远端胃癌根治术,无术中死亡病例及中转开腹病例,平均手术时间(125.30±26)min,平均淋巴结清扫数目为(38.30±6.22)枚,平均失血量(60.42±10.10)mL,术后首次肛门排气时间平均为(32.30±11.00)h,术后平均住院时间为(9.62±3.21)d.术后出现轻度胃瘫1例,经空肠营养管肠内营养治疗后痊愈,术后1例患者拔出尿管后出现尿潴留1例,经导尿并训练膀胱功能后痊愈.所有病例康复出院.结论 达芬奇机器人远端胃癌根治术手术安全可行,正确的护理干预措施,科学的围手术期护理是患者早日康复的有利保证.

Nursing experience of 15 cases of robotic-assisted radical gastrectomy using da Vinci robotic system

Objective To explore the perioperative nursing approach for robotic-assisted radical gastrectomy using da Vinci robotic system. Methods Retrospective analysis was performed on the clinical data of 15 patients under-going surgery with da Vinci robot for distal gastric cancer in January 2017 in Department of General Surgery. Before sur-gery, patients were educated on surgery with da Vinci robot, in an attempt to demonstrate its superiority and build pa-tients' assurance in fighting against the disease;patients with nutritional risk before surgery received diet instruction;the surgery was well prepared. After surgery, vital signs were closely monitored, pain management and various catheter care including gastric tube were in place, and the patients were encouraged to ambulate early to facilitate recovery of gastroin-testinal function. Results All the 15 patients had successful robotic-assisted radical gastrectomy using da Vinci robotic system without significant postoperative complications, and were discharged after recovery. The average operation time was (125.30±26) minutes;the mean number of lymph nodes was (38.30±6.22);the mean blood loss was (60.42±10.10) mL; the average exsufflation time of anus was (32.30 ± 11.00) hours and the average postoperative hospital stay was (9.62±3.21) days. After surgery, there was one case of mild gastric paralysis who recovered after the nutritional treatment of enteral nutrition; there also was one case of urinary retention after pulling out the catheter, who recovered after the catheterization and training of bladder function. Conclusion Robotic-assisted radical gastrectomy using da Vinci robot-ic system is safe and feasible. The appropriate nursing interventions and scientific perioperative nursing are essential for patients to recover early.