规范化手术护理配合在肝胆胰脾外科机器人中转开腹手术中的应用研究
Research on the Application of Standardized Surgical Nursing Cooperation in the Conversion of Robot-Assisted Laparoscopic Surgery to Open Surgery in Hepatobiliary Pancreatic Surgery
摘要: 目的：分析总结规范化手术护理配合对肝胆胰脾外科手术中机器人中转开腹患者影响，为建立术中医护精准配合提供参考依据。方法：选择2018年1月至2023年3月海军军医大学附属长海医院肝胆胰外科择期行机器人辅助手术中转开腹的肝胆胰患者分为规范化护理组和常规护理组，比较中转开腹两组患者的基本信息、手术时间、术中出血量、苏醒时间以及住院时间。结果：57例患者随机分为两组，一组为常规护理配合组29例；另一组为规范化护理组28例。规范化组的手术时长小于常规组(221.61 ± 52.73 vs 189.22 ± 48.70, P = 0.02)，术中出血量小于常规组(443 ± 7 vs 378 ± 4, P < 0.001)，苏醒时长小于常规组(25.97 ± 4.01 vs 16.33 ± 8.39, P < 0.001)，术后住院天数小于常规组(21.20 ± 8.12 vs 17.37 ± 3.47, P = 0.03)。结论：制定机器人手术中转开腹的规范化护理流程可明显缩短患者的手术时长、减少术中出血量、缩短麻醉苏醒时长以及缩短术后住院天数。
Abstract: Objective: To analyze and summarize the impact of standardized surgical nursing cooperation on patients undergoing robot-assisted surgery with the reversion to open surgery in hepatobiliary and pancreatic surgery, and to provide a reference basis for establishing precise medical-nursing cooperation during surgery. Methods: From January 2018 to March 2023, patients undergoing robot-assisted surgery with robot reversion to open surgery in the hepatobiliary and pancreatic surgery department of the Changhai Hospital Affiliated to Naval Medical University were randomly divided into the standardized nursing group and the conventional nursing group. The basic information, operation time, intraoperative blood loss, awakening time, and hospital stay of the two groups of patients undergoing robot reversion to open surgery were compared. Results: 57 patients were randomly divided into two groups, with 29 cases in the conventional nursing cooperation group and 28 cases in the standardized nursing group. The operation time of the standardized group was shorter than that of the conventional group (221.61 ± 52.73 vs 189.22 ± 48.70, P = 0.02), the intraoperative blood loss was less than that of the conventional group (443 ± 7 vs 378 ± 4, P < 0.001), the awakening time was shorter than that of the conventional group (25.97 ± 4.01 vs 16.33 ± 8.39, P < 0.001), and the postoperative hospital stay was shorter than that of the conventional group (21.20 ± 8.12 vs 17.37 ± 3.47, P = 0.03). Conclusion: The establishment of standardized nursing procedures for robot-assisted surgery reversion to open surgery can significantly shorten the operation time, reduce intraoperative blood loss, shorten the anesthesia awakening time, and shorten the postoperative hospital stay.
文章引用：宋红雁, 季秋芳, 单晴, 代姗姗, 丁瑞芳. 规范化手术护理配合在肝胆胰脾外科机器人中转开腹手术中的应用研究[J]. 护理学, 2026, 15(8): 50-56. https://doi.org/10.12677/ns.2026.158246

参考文献

[1] 顾磊, 詹茜, 邓侠兴, 等. “达芬奇”机器人在肝胆胰手术中的应用(单中心报道) [J]. 外科理论与实践, 2013, 18(3): 275-280.
[2] 王辉, 丁鹏勋, 任天尧, 等. 1例达芬奇机器人辅助胰体尾脾切除联合左肾部分切除的护理[J]. 护理学报, 2021, 28(10): 75-76.
[3] Spiegelberg, J., Iken, T., Diener, M.K. and Fichtner-Feigl, S. (2022) Robotic-Assisted Surgery for Primary Hepatobiliary Tumors—Possibilities and Limitations. Cancers, 14, Article No. 265.
https://doi.org/10.3390/cancers14020265
[4] Morel, P., Jung, M., Cornateanu, S., Buehler, L., Majno, P., Toso, C., et al. (2017) Robotic versus Open Liver Resections: A Case‐Matched Comparison. The International Journal of Medical Robotics and Computer Assisted Surgery, 13, e1800.
https://doi.org/10.1002/rcs.1800
[5] 秦雯, 朱琴. 80例单辅助孔达芬奇机器人肝切除手术的护理配合[J]. 全科护理, 2023, 21(9): 1212-1215.
[6] Sucandy, I., Rayman, S., Lai, E.C., Tang, C., Chong, Y., Efanov, M., et al. (2022) Robotic versus Laparoscopic Left and Extended Left Hepatectomy: An International Multicenter Study Propensity Score-Matched Analysis. Annals of Surgical Oncology, 29, 8398-8406.
https://doi.org/10.1245/s10434-022-12216-6
[7] Buell, J.F., Cherqui, D., Geller, D.A., O’Rourke, N., Iannitti, D., Dagher, I., et al. (2009) The International Position on Laparoscopic Liver Surgery: The Louisville Statement, 2008. Annals of Surgery, 250, 825-830.
https://doi.org/10.1097/sla.0b013e3181b3b2d8
[8] 张春旭, 韩军军, 刘杰, 等. 腹腔镜肝切除术治疗肝内胆管结石中转开腹的原因分析及预防[J]. 肝胆胰外科杂志, 2021, 33(4): 213-217.
[9] 穆森茂, 李德宇. 腹腔镜肝切除术中转开腹时机把握[J]. 肝胆外科杂志, 2019(4): 287-289.
[10] 夏云. 护理品管圈在缩短腔镜手术接台时间管理中的应用效果观察[J]. 医学理论与实践, 2020, 33(8): 1340-1342.
[11] 吴健, 王波, 皮勇, 等. 丙泊酚联合不同浓度七氟烷维持全麻对老年腹腔镜手术患者苏醒时间及术后认知功能的影响[J]. 中国老年学杂志, 2024, 44(16): 3901-3903.
[12] 郑绘, 付琴. 复合保温措施联合麻醉苏醒护理在腹腔镜全子宫切除术病人中的应用[J]. 蚌埠医学院学报, 2024, 49(8): 1121-1125.
[13] Schwenk, W. (2022) Optimized Perioperative Management (Fast-Track, ERAS) to Enhance Postoperative Recovery in Elective Colorectal Surgery. GMS Hygiene and Infection Control, 17, Doc10.
[14] Abrishamkar, S., Karimi, M., Safavi, M., et al. (2010) Effects of Intraoperative-Intrathecal Sufentanil Injection on Postoperative Pain Management after Single Level Lumbar Discectomy. Middle East Journal of Anesthesiology, 20, 839-844.
[15] Xu, X., Cheung, D.S.T., Smith, R., Lai, A.Y.K. and Lin, C. (2022) The Effectiveness of Pre-and Post-Operative Rehabilitation for Lung Cancer: A Systematic Review and Meta-Analysis on Postoperative Pulmonary Complications and Length of Hospital Stay. Clinical Rehabilitation, 36, 172-189.
https://doi.org/10.1177/02692155211043267
[16] Cai, P., Wu, L., Dai, L., Yan, Q. and Lan, Q. (2024) Clinical Efficacy of Refined Nursing Strategies on Early Rehabilitation Training for Postoperative Patients with Cervical Spondylosis. Medicine, 103, e38127.
https://doi.org/10.1097/md.0000000000038127
[17] Sauro, K.M., Smith, C., Ibadin, S., Thomas, A., Ganshorn, H., Bakunda, L., et al. (2024) Enhanced Recovery after Surgery Guidelines and Hospital Length of Stay, Readmission, Complications, and Mortality: A Meta-Analysis ofRandomized Clinical Trials. JAMA Network Open, 7, e2417310.
https://doi.org/10.1001/jamanetworkopen.2024.17310

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