全机器人辅助3D高清胸腔镜下房间隔缺损修补术的护理管理
|
摘要
目的总结29例全机器人辅助3D高清胸腔镜下房间隔缺损修补术的护理特点及体会,为今后的临床管理提供护理依据。方法回顾性分析2016年12月至2017年7月南京医科大学第一附属医院心脏大血管外科29例行全机器人辅助3D高清胸腔镜下房间隔缺损修补术患者的临床资料,总结围手术期在系统规范的护理管理下实施护理的效果和体会。结果 29例患者均手术顺利,无1例中转开胸。手术时间为(1.25±0.37)h,术中失血量为(132.36±15.26)ml;术后重症监护16~22 h,术后首次排气时间(24.1±3.35)h、首次进食时间(16.5±2.43)h、首次下床时间(2.96±0.08)d,术后平均住院日(12.4±2.6)d,无并发症发生。随访期间无1例死亡、复发。结论系统规范管理全机器人辅助3D高清胸腔镜下房间隔缺损修补术围手术期的护理措施,有助于促进患者快速康复。
Objective To summarize the experience of nursing management for the patients receiving atrial septal defect repair under 3D HD thoracoscopy assisted with whole robot. Methods The clinical data from 29 cases receiving atrial septal defect repair by 3D HD thoracoscopic assisted with whole robot were analyzed retrospectively. The experiences of perioperative nursing management were summarized. Results All the 29 patients were successfully completed without thoracotomy. The average of operation time was( 1. 25±0. 37) h,intraoperative blood loss was( 132. 36±15. 26) ml. It took patients 16-22 hours in postoperative intensive care. After the operation,the average of first exhaust time was( 24. 1±3. 35) h,eating for the first time was( 16. 5± 2. 43) h,bed time was( 2. 96±0. 08) d,hospitalization days was( 12. 4±2. 6) d. The postoperative rehabilitation was uneventful,and no complications occurred. No death or recurrence occurred during the follow-up period. Conclusion Systematic and standard perioperative nursing measures of 3D HD thoracoscopy assisted with whole robot for the patients receiving atrial septal defect repair are helpful.
Objective To summarize the experience of nursing management for the patients receiving atrial septal defect repair under 3D HD thoracoscopy assisted with whole robot. Methods The clinical data from 29 cases receiving atrial septal defect repair by 3D HD thoracoscopic assisted with whole robot were analyzed retrospectively. The experiences of perioperative nursing management were summarized. Results All the 29 patients were successfully completed without thoracotomy. The average of operation time was( 1. 25±0. 37) h,intraoperative blood loss was( 132. 36±15. 26) ml. It took patients 16-22 hours in postoperative intensive care. After the operation,the average of first exhaust time was( 24. 1±3. 35) h,eating for the first time was( 16. 5± 2. 43) h,bed time was( 2. 96±0. 08) d,hospitalization days was( 12. 4±2. 6) d. The postoperative rehabilitation was uneventful,and no complications occurred. No death or recurrence occurred during the follow-up period. Conclusion Systematic and standard perioperative nursing measures of 3D HD thoracoscopy assisted with whole robot for the patients receiving atrial septal defect repair are helpful.
引文
[1]周宁新.机器人微创外科手术探索与实践[M].北京:人民军医出版社,2010:24.
[2]Herron DM,Marohn M,SAGES-MIRA Robotic Surgery Consensus Group.A consensus document on robotic surgery[J].Surg Endosc,2008,22(2):313-325.
[3]张翠娟,丁艳琼,冯锦茶,等.心理护理干预对全机器人心脏手术患者的影响[J].护士进修杂志,2014,29(14):1282-1283.
[4]马春霞.活性银离子抗菌液应用于老年糖尿病患者口腔护理[J].护理学杂志,2014,29(9):43-44.
[5]任海记,张翠娟,傅美东,等.全机器人微创房间隔缺损修补术54例病房管理[J].齐鲁护理杂志,2017,23(14):8-10.
[6]李细森,郑宝石.心脏瓣膜置换术同期行冠状动脉旁路移植术围术期护理[J].微创医学,2014,5(23):624.
[7]杨莉莉,李荣,刘英,等.临床护理路径在心脏瓣膜置换围术期患者护理中的应用效果[J].解放军护理杂志,2015,14(15):44.
[8]张翠娟,唐锋媚,任海记,等.全机器人二尖瓣置换术的围手术期护理[J].护士进修杂志,2016,31(14):1301-1304.
[9]周爱芳.心脏瓣膜置换术后ICU监护的临床护理[J].实用临床医药杂志,2016,20(12):157-158.
[10]丁艳琼,康文斌,冯锦茶,等.全机器人心脏手术后患者早期疼痛的观察及护理[J].解放军医学院学报,2013,34(7):744-745.
[11]曾小平,罗帆,唐维娟.电视胸腔镜手术患者的临床观察及护理[J].护士进修杂志,2010,25(14):1322-1323.
[12]翁卫群,陈卫军,严丽华.早期活动干预对心脏直视手术患者术后康复的影响[J].实用临床医药杂志,2012,16(14):49-51.
[13]杜梅青,杨鸿儿.体外循环心脏手术后胃肠功能紊乱的个体化护理[J].实用临床医学,2014,15(1):120-121.
[14]Bodner J,Wykypiel H,Greiner A,et al.Early experience with robot-assisted surgery for mediastinal masses[J].Ann Thorac Surg,2004,78(1):259-265.
[15]何哲浩,杨运海,张翀,等.达芬奇机器人胸部手术后优化胸腔引流策略的初步探索[J].中国胸心血管外科临床杂志,2015,22(10):919-922.
[2]Herron DM,Marohn M,SAGES-MIRA Robotic Surgery Consensus Group.A consensus document on robotic surgery[J].Surg Endosc,2008,22(2):313-325.
[3]张翠娟,丁艳琼,冯锦茶,等.心理护理干预对全机器人心脏手术患者的影响[J].护士进修杂志,2014,29(14):1282-1283.
[4]马春霞.活性银离子抗菌液应用于老年糖尿病患者口腔护理[J].护理学杂志,2014,29(9):43-44.
[5]任海记,张翠娟,傅美东,等.全机器人微创房间隔缺损修补术54例病房管理[J].齐鲁护理杂志,2017,23(14):8-10.
[6]李细森,郑宝石.心脏瓣膜置换术同期行冠状动脉旁路移植术围术期护理[J].微创医学,2014,5(23):624.
[7]杨莉莉,李荣,刘英,等.临床护理路径在心脏瓣膜置换围术期患者护理中的应用效果[J].解放军护理杂志,2015,14(15):44.
[8]张翠娟,唐锋媚,任海记,等.全机器人二尖瓣置换术的围手术期护理[J].护士进修杂志,2016,31(14):1301-1304.
[9]周爱芳.心脏瓣膜置换术后ICU监护的临床护理[J].实用临床医药杂志,2016,20(12):157-158.
[10]丁艳琼,康文斌,冯锦茶,等.全机器人心脏手术后患者早期疼痛的观察及护理[J].解放军医学院学报,2013,34(7):744-745.
[11]曾小平,罗帆,唐维娟.电视胸腔镜手术患者的临床观察及护理[J].护士进修杂志,2010,25(14):1322-1323.
[12]翁卫群,陈卫军,严丽华.早期活动干预对心脏直视手术患者术后康复的影响[J].实用临床医药杂志,2012,16(14):49-51.
[13]杜梅青,杨鸿儿.体外循环心脏手术后胃肠功能紊乱的个体化护理[J].实用临床医学,2014,15(1):120-121.
[14]Bodner J,Wykypiel H,Greiner A,et al.Early experience with robot-assisted surgery for mediastinal masses[J].Ann Thorac Surg,2004,78(1):259-265.
[15]何哲浩,杨运海,张翀,等.达芬奇机器人胸部手术后优化胸腔引流策略的初步探索[J].中国胸心血管外科临床杂志,2015,22(10):919-922.