Effect of Da Vinci robot-assisted laparoscopy on urination function and comfort in patients undergoing preresection for rectal cancer
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摘要:目的
探讨达芬奇机器人辅助腹腔镜对直肠癌前切除术患者排尿功能及舒适度的影响。
方法选取48例行达芬奇机器人辅助腹腔镜直肠癌前切除术的患者为研究对象，并纳入机器人组。另选取同期单纯行腹腔镜的患者51例纳入腹腔镜组。比较2组患者术后尿管拔除时间、排尿成功率、留置尿管相关并发症(尿频、尿急、尿痛、尿潴留)发生率、最大尿流率和膀胱残余尿量、排尿功能、尿培养阳性率、睡眠时间以及舒适度。
结果机器人组患者术后留置尿管拔除时间早于腹腔镜组，膀胱残余尿量少于腹腔镜组，差异有统计学意义(P < 0.05)。机器人组成功排尿率、最大尿流率高于腹腔镜组，并发症发生率(尿频、尿急、尿痛和尿潴留)低于腹腔镜组，差异有统计学意义(P < 0.05)。2组尿培养阳性率比较，差异无统计学意义(P>0.05)。机器人组排尿功能优于腹腔镜组，排尿功能障碍率低于腹腔镜组，差异有统计学意义(P < 0.05)。机器人组睡眠时间长于腹腔镜组，机器人组舒适度高于腹腔镜组，差异有统计学意义(P < 0.001)。
结论在达芬奇机器人辅助腹腔镜下行直肠癌前切除术，可缩短患者的尿管留置时间，提高排尿成功率，降低留置尿管相关并发症的发生率，减轻患者疼痛程度，提高舒适度。
Abstract:ObjectiveTo investigate the effect of Da Vinci robot-assisted laparoscopy on urination function and comfort in patients undergoing preresection for rectal cancer.
MethodsForty-eight patients who underwent Da Vinci robot-assisted laparoscopic preresection for rectal cancer were selected as the study objects and included in the robot group.Another 51 patients who underwent laparoscopy alone during the same period were included in the laparoscopic group.The time of catheter removal, the success rate of urination, the incidence of complications related to catheter indwelling (frequency of urination, urgency of urination, pain of urination and retention of urine), the maximum urine flow rate and residual urine volume of bladder, urination function, positive rate of urine culture, sleep duration and patient comfort were compared between the two groups.
ResultsThe removal time of indentation catheter in the robot group was significantly earlier, and the residual urinary volume of bladder was significantly less than that in the laparoscopic group (P < 0.05).The rate of successful urination and maximum urinary flow rate in the robot group was significantly higher, and the rate of complications (frequency of urination, urgency of urination, urinalgia and urinary retention) and maximum urinary flow rate were significantly lower than those in the laparoscopic group (P < 0.05). There was no significant difference in the positive rate of urine culture between the two groups (P> 0.05).The urinary function of the robot group was significantly better, and the rate of urinary dysfunction was significantly lower than that of the laparoscopic group (P < 0.05).The sleep time of the robot group was significantly longer, and the comfort level of the robot group was significantly higher than that of the laparoscopic group (P < 0.001).
ConclusionThe Da Vinci robot-assisted laparoscopic preresection of rectal cancer can shorten the catheter indwelling time of patients, improve the success rate of urination, relieve the incidence of complications related to catheter indwelling, relieve the pain degree of patients, and improve comfort.
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Keywords:
- indwelling catheter /
- Da Vinci robot /
- laparoscope /
- prerectal resection /
- complications /
- comfort degree
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表 1 2组基线资料比较(x±s)[n(%)]
一般资料 分类 机器人组(n=48) 腹腔镜组(n=51) t/χ2 P 性别 男 30(62.50) 27(52.94) 0.925 0.336 女 18(37.50) 24(47.06) 年龄/岁 56.58±7.69 58.53±6.40 -1.365 0.176 体质量指数/(kg/m2) 22.70±2.24 22.77±2.24 -0.137 0.892 术前新辅助治疗 6(12.50) 4(7.84) 0.189 0.442 肿瘤距肛缘的距离/cm 3.71±0.48 3.78±0.46 -0.742 0.460 
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表 2 2组患者尿管拔除时间、排尿成功率、留置尿管并发症发生率比较(x±s)[n(%)]
组别 n 尿管拔除时间/d 成功排尿 尿频 尿急 尿痛 尿潴留 机器人组 48 2.99±0.82* 46(95.83)* 2(4.16)* 1(2.08)* 3(6.25)* 2(4.17)* 腹腔镜组 51 3.45±1.13 42(82.35) 9(17.65) 8(15.68) 11(21.57) 9(17.65) 与机器人组比较, * P < 0.05。
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表 3 2组患者尿管后最大尿流率、膀胱残余尿量、尿培养阳性率比较(x±s)[n(%)]
组别 n 最大尿流率/(mL/s) 膀胱残余尿量/mL 尿培养阳性 机器人组 48 35.33±3.45* 17.52±4.21* 1(2.08) 腹腔镜组 51 27.46±3.24 23.19±3.82 3(5.88) 与机器人组比较, * P < 0.05。
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表 4 2组患者排尿功能比较[n(%)]
组别 n 排尿功能 排尿障碍 Ⅰ级 Ⅱ级 Ⅲ级 Ⅳ级 机器人组 48 40(83.33) 5(10.42) 1(2.08) 2(4.17) 8(16.67)* 腹腔镜组 51 33(64.71) 4(7.84) 6(11.76) 8(15.69) 18(35.29) 与机器人组比较, * P < 0.05。
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表 5 2组患者睡眠时间比较[n(%)]
组别 n < 4 h 4~ < 6 h 6~ < 8 h ≥8 h 机器人组 48 5(10.42) 11(22.92) 20(41.67) 12(25.00) 腹腔镜组 51 14(27.45) 22(43.14) 11(21.57) 4(7.84)
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表 6 2组患者舒适度比较[n(%)]
组别 n 0度 Ⅰ度 Ⅱ度 Ⅲ度 机器人组 48 24(50.00) 12(25.00) 8(16.67) 4(8.33) 腹腔镜组 51 12(23.53) 5(9.80) 19(37.25) 15(29.41)
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