腹腔镜下结直肠癌根治术的时间效应分析(1)
摘要：目的 调查不同术者行腹腔镜下结直肠癌根治术对手术时间、手术室医护人员加班、麻醉科和手术室开支、麻醉药占比等的影响。方法 选择2015年1月～2016年8月在我院择期行腹腔镜下结肠或直肠癌根治术(Dixon)患者110例，根据主刀医生将患者分为三组。采用资料摘录表对符合入选标准和排除标准的病例进行资料摘录并纳入统计学分析。结果 三组患者手术时间为：组1：(220±40) min；组2：(253±57) min；组3：(251±64) min。组1和组2、组3比较差异有统计学意义(P<0.05)。医护人员加班率、麻醉科和手术室开支、麻醉药占比等均有一定程度的增加(P<0.05)。結论 相同职称级别的术者主刀行腹腔镜下结直肠癌根治术时，时间存在较大差异。手术时间越长，医护人员加班、手术室开支、麻醉药占比亦相应增加。
关键词： 腹腔镜，结直肠癌，根治术；时间
中图分类号：R735 文献标识码：A 文章编号：1006-1959(2017)16-0046-02
, http://www.100md.com
Time Effect Analysis of Laparoscopic Radical Resection for Colorectal Cancer
WU Zhi-guo1，YUAN Wan-qiu1，YE Qing-lin2，PENG Hong1
(Department of Anesthesiology1，Operation Room2，Pingxiang People's Hospital of Jiangxi Province，Pingxiang 337055，Jiangxi，China)
Abstract：Objective To investigate the effect of laparoscopic radical resection of colorectal cancer on the operation time，operation room，medical staff overtime，anesthesia and operation room expenses，anesthetic ratio.Methods In January 2015～August 2016 in our hospital for radical resection of colon or rectal cancer undergoing laparoscopic(Dixon)patients with 110 cases，according to the doctor in charge of the patients were divided into three groups.Data extraction table was used to extract the data which fit the inclusion criteria and exclusion criteria，and then included in the statistical analysis.Results The operation time of the three groups was：group 1：220±40 min；group 2：253±57 min；group 3：251±64 min.Group 1 and group 2，group 3 was statistically significant difference(P<0.05).The overtime rate of medical staff， the expenditure of anesthesia and operation room and the proportion of narcotic drugs increased to some extent(P<0.05).Conclusion There is a significant difference in the time of laparoscopic radical resection of colorectal cancer at the same title level.The longer the operation time，health care workers overtime，operating room expenses，the proportion of anesthesia also increased accordingly.
, http://www.100md.com
Key words：Laparoscopy；Colorectal cancer；Radical resection；Time
1资料与方法
1.1一般资料
本研究旨在调查同一职称级别，不同主刀医生对手术时间、手术室医护人员加班、麻醉科和手术室开支、麻醉药占比等的影响。将2015年1月～2016年8月择期行腹腔镜结肠或直肠癌根治术(Dixon)患者纳入研究。三名主刀医师均为副主任医师，根据主刀医师不同将患者分为三组：组1为X组；组2为H组；组3为G组。排除标准：开腹手术、复杂手术方式、腹腔镜下Miles手术和Hartman手术、中途停止的手术、中转开腹的手术。
1.2方法
1.2.1麻醉过程 患者入手术室后，行桡动脉穿刺置管监测IBP、心电图、血氧饱和度、心率、呼气末二氧化碳。右颈内或者右锁骨下静脉穿刺置管。全凭静脉麻醉诱导后，术中以丙泊酚、瑞芬太尼、顺式阿曲库铵和七氟醚静吸复合麻醉维持。术毕清醒拔除气管导管入麻醉复苏室。手术超过16：30以后，麻醉复苏室关闭，患者则在手术室内复苏再返回病房。
1.2.2手术过程 置入Trocar建立气腹，探查后超声刀离断肠系膜下血管，游离肿瘤肠管，切断后下腹作纵行4 cm切口进腹，移去标本断端，距离肿瘤上缘10 cm处切断结肠，荷包缝合后置入吻合器钉座，肛门置入吻合器基座对接吻合。随后止血放置引流管，退出Trocar关腹。, http://www.100md.com(巫志国 袁婉秋 叶青林 彭洪)
关键词： 腹腔镜，结直肠癌，根治术；时间
中图分类号：R735 文献标识码：A 文章编号：1006-1959(2017)16-0046-02
, http://www.100md.com
Time Effect Analysis of Laparoscopic Radical Resection for Colorectal Cancer
WU Zhi-guo1，YUAN Wan-qiu1，YE Qing-lin2，PENG Hong1
(Department of Anesthesiology1，Operation Room2，Pingxiang People's Hospital of Jiangxi Province，Pingxiang 337055，Jiangxi，China)
Abstract：Objective To investigate the effect of laparoscopic radical resection of colorectal cancer on the operation time，operation room，medical staff overtime，anesthesia and operation room expenses，anesthetic ratio.Methods In January 2015～August 2016 in our hospital for radical resection of colon or rectal cancer undergoing laparoscopic(Dixon)patients with 110 cases，according to the doctor in charge of the patients were divided into three groups.Data extraction table was used to extract the data which fit the inclusion criteria and exclusion criteria，and then included in the statistical analysis.Results The operation time of the three groups was：group 1：220±40 min；group 2：253±57 min；group 3：251±64 min.Group 1 and group 2，group 3 was statistically significant difference(P<0.05).The overtime rate of medical staff， the expenditure of anesthesia and operation room and the proportion of narcotic drugs increased to some extent(P<0.05).Conclusion There is a significant difference in the time of laparoscopic radical resection of colorectal cancer at the same title level.The longer the operation time，health care workers overtime，operating room expenses，the proportion of anesthesia also increased accordingly.
, http://www.100md.com
Key words：Laparoscopy；Colorectal cancer；Radical resection；Time
1资料与方法
1.1一般资料
本研究旨在调查同一职称级别，不同主刀医生对手术时间、手术室医护人员加班、麻醉科和手术室开支、麻醉药占比等的影响。将2015年1月～2016年8月择期行腹腔镜结肠或直肠癌根治术(Dixon)患者纳入研究。三名主刀医师均为副主任医师，根据主刀医师不同将患者分为三组：组1为X组；组2为H组；组3为G组。排除标准：开腹手术、复杂手术方式、腹腔镜下Miles手术和Hartman手术、中途停止的手术、中转开腹的手术。
1.2方法
1.2.1麻醉过程 患者入手术室后，行桡动脉穿刺置管监测IBP、心电图、血氧饱和度、心率、呼气末二氧化碳。右颈内或者右锁骨下静脉穿刺置管。全凭静脉麻醉诱导后，术中以丙泊酚、瑞芬太尼、顺式阿曲库铵和七氟醚静吸复合麻醉维持。术毕清醒拔除气管导管入麻醉复苏室。手术超过16：30以后，麻醉复苏室关闭，患者则在手术室内复苏再返回病房。
1.2.2手术过程 置入Trocar建立气腹，探查后超声刀离断肠系膜下血管，游离肿瘤肠管，切断后下腹作纵行4 cm切口进腹，移去标本断端，距离肿瘤上缘10 cm处切断结肠，荷包缝合后置入吻合器钉座，肛门置入吻合器基座对接吻合。随后止血放置引流管，退出Trocar关腹。, http://www.100md.com(巫志国 袁婉秋 叶青林 彭洪)
参见：首页 > 医疗版 > 疾病专题 > 消化内科 > 肠道疾病 > 类癌及类癌综合征 > 结、直肠癌