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机器人辅助下肾部分切除术患者分级干预对静脉血栓栓塞的预防效果

Preventive effect of hierarchical intervention in patients with robot-assisted partial nephrectomy on venous thromboembolism

    摘要
  • 摘要:
    目的 观察机器人辅助下肾部分切除术患者分级干预对下肢静脉血栓栓塞(VTE)的预防效果。
    方法 选取76例肾肿瘤切除术患者为研究对象，随机分为对照组和观察组，每组38例。术后，对照组给予常规护理，观察组给予基于R.E.N.A.L肾脏测量评分系统下的分级干预。比较2组并发症发生情况、康复指标、凝血指标、生活质量及护理满意度。
    结果 干预后，观察组下肢肿痛、VTE及总并发症发生率均低于对照组，差异有统计学意义(P < 0.05)。观察组的排气时间、输液时间、自主活动时间、住院时间短于对照组，费用开支低于对照组，差异有统计学意义(P < 0.05)。观察组活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)短于对照组，纤维蛋白原(FBG)、D-二聚体(D-D)水平低于对照组，差异有统计学意义(P < 0.05)。干预后, 2组患者的生活质量各指标(生理情况、心理状态、独立状态、环境、精神支持、社会关系)评分与总分高于干预前，且观察组高于对照组，差异有统计学意义(P < 0.05)。观察组患者干预期间护理满意度为97.37%, 高于对照组的71.05%, 差异有统计学意义(P < 0.05)。
    结论 对机器人辅助腹腔镜下肾部分切除术患者行分级干预，可有效预防其下肢肿痛、VTE，促进其术后恢复，进而缩短住院时间和降低治疗费用，以及提高患者生活质量和护理满意度。

     

    Abstract:
    Objective To observe the preventive effect of hierarchical intervention in patients with robot-assisted partial nephrectomy on venous thromboembolism (VTE) of lower limbs.
    Methods A total of 76 patients with renal tumor resection were selected as the study objects, and were randomly divided into control group and observation group, with 38 cases in each group. After operation, the control group was given routine nursing, and the observation group was given graded intervention based on the R.E.N.A.L renal measurement scoring system. The incidence of complications, rehabilitation index, coagulation index, quality of life and nursing satisfaction were compared between the two groups.
    Results After intervention, the incidence of lower limb pain and swelling, the incidence of VTE and total complications in the observation group were significantly lower than those in the control group (P < 0.05). The exhaust time, infusion time, autonomous activity time and hospitalization stay of the observation group were significantly shorter, and the expenditure was significantly lower than that of the control group (P < 0.05). The activated partial thromboplastin time (APTT) and prothrombin time (PT) in the observation group were significantly shorter, and the levels of fibrinogen (FBG) and D-dimer (D-D) in the observation group were significantly lower than those in the control group (P < 0.05). After intervention, the scores and total scores of all indexes of quality of life (physiological condition, psychological state, independent state, environment, spiritual support and social relationship) in two groups were significantly higher, and the observation group was significantly higher in above indicators than the control group (P < 0.05). The nursing satisfaction of observation group was 97.37%, which was significantly higher than 71.05% of control group (P < 0.05).
    Conclusion Hierarchical intervention for patients with robot-assisted laparoscopic partial nephrectomy can effectively prevent lower limb pain, swelling and VTE, promote postoperative recovery, shorten hospital stay and reduce treatment costs, and improve patients' quality of life and nursing satisfaction.

     

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