目的：探究达芬奇机器人辅助下肝癌根治术的临床疗效以及护理路径在患者围手术期的应用效果。 方法：选取 2020 年 1 月—2022 年 12 月在四川省人民医院和成都市第三人民医院接受达芬奇机器人辅助下肝癌根治 术的 80 例患者，采用随机数字表法将其分为研究组和对照组，各 40 例。对照组给予常规护理干预，研究组给予临 床护理路径（CNP）。对比两组临床疗效、肝功能指标、生活质量评分、心理状态评分及住院指标。结果：所有手 术均顺利完成，仅有 1 例胆漏，3 例肝断面积液，经保守治疗后相关患者症状均消失；随访 6~36 个月所有患者均无 复发或死亡；比较两组术后肝功能指标、各项生活质量评分、心理状态评分，差异具有统计学意义（P>0.05）；出 院前，两组肝功能指标和心理状态评分均明显降低，两组各项生活质量评分均明显升高，且研究组明显优于对照组， 差异具有统计学意义（P<0.05）；研究组卧床时间、住院时间、住院费用明显低于对照组，差异具有统计学意义（P<0.05）。 结论：达芬奇机器人辅助下肝癌根治术能够取得良好的手术效果。同时与传统护理干预措施相比，临床护理路径构 建的标准化护理流程能够改善患者肝功能、提高生活质量、调节不良情绪，具有较高的临床应用和推广价值。

Objective: To explore the clinical efficacy of Da Vinci robot-assisted liver cancer radical resection and nursing pathway during perioperative period. Methods: A total of 80 patients who received robot-assisted liver cancer radical resection in Sichuan People’s Hospital and the Third People’s Hospital of Chengdu from January 2020 to December 2022 were selected and divided into the study group(n=40) and the control group(n=40)by random number table method. The control group was given routine nursing intervention, and the study group was given clinical nursing pathway. The clinical efficacy, liver function indexes, quality of life scores, psychological scores and hospitalization indexes were compared between the two groups. Results: All the operations were successfully completed, only 1 case of bile leakage, 3 cases of liver sectional effusion. After conservative treatment, symptoms of the relevant patients disappeared, and all patients were followed up for 6-36 months without recurrence or death. The liver function indexes, quality of life (QoL) scores and psychological scores were compared between the two groups, and the differences were statistically significant (P>0.05). Before discharge, liver function indexes and psychological scores of both groups were significantly decreased, and QoL scores of both groups were significantly increased, and the study group was significantly better than the control group, the difference was statistically significant (P<0.05). The bed time, hospital stay and hospital costs of the study group were significantly lower than those of the control group, and the differences were statistically significant (P<0.05). Conclusion: Da Vinci robot-assisted liver cancer radical resection could achieve good surgical results. Compared with traditional nursing interventions, clinical nursing pathways could improve patients’ liver function, improve QoL, regulate negative emotions, and have better clinical application and promotion value.

收稿日期：2023-12-13  录用日期：2024-03-19 

Received Date: 2023-12-13  Accepted Date: 2024-03-19 

基金项目：四川省心理健康教育研究中心课题（XLJKJY202107C）；2024 年德阳市人民医院院内孵化课题（FHT202406） 

Foundation Item: Project of Sichuan Mental Health Education Research Center( XLJKJY202107C); Internal Incubation Project of Deyang People’s Hospital in 2024(FHT202406) 

通讯作者：杨亚梅，Email：547069117@qq.com 

Corresponding Author: YANG Yamei, Email: 547069117@qq.com 

引用格式：刘竹，曾月薇，谭洁，等 . 达芬奇机器人辅助下肝癌根治术的临床疗效及围手术床护理路径的构建 [J]. 机器人外科学杂 志（中英文），2024，5（3）：392-398. 

Citation: LIU Z, ZENG Y W, TAN J, et al. Efficacy of Da Vinci robot-assisted liver cancer radical resection and construction of postoperative nursing pathway [J]. Chinese Journal of Robotic Surgery, 2024, 5(3): 392-398.

[1] 刘亚芳 , 贾海妮 . 临床护理路径在肝癌介入术后 护理中的应用效果观察 [J]. 中国肿瘤临床与康复 , 2022, 29(6): 766-768. 

[2] 吴淑卿 , 詹淑珠 , 杨盼 . 分析临床护理路径对肝癌 介入治疗患者的临床疗效与睡眠质量影响 [J]. 世界 睡眠医学杂志 , 2022, 9(11): 2183-2185, 2188. 

[3] CHEN S C, WU S F, WANG T J, et al. Factors influencing the coping strategies of liver cancer patients undergoing transarterial chemoembolization[J]. Int J Nurs Pract, 2022, 28(4): e13033. 

[4] 黄超燕 , 董彩霞 , 彭登辉 . 临床护理路径对肝癌介 入治疗患者护理满意度及生存质量的影响分析 [J]. 黑龙江中医药 , 2022, 51(6): 196-198. 

[5] Pham C, Sin M K. Use of electronic health records at federally qualified health centers: a potent tool to increase viral hepatitis screening and address the climbing incidence of liver cancer[J]. J Cancer Educ, 2021, 36(5): 1093-1097. 

[6] 杨雅丽 . 临床护理路径在索拉非尼治疗原发性肝癌 患者中的应用效果 [J]. 中国民康医学 , 2022, 34(1): 177-179. 

[7] 安帅 , 孙文莉 . 临床护理路径在肝癌射频消融术患 者中的应用 [J]. 齐鲁护理杂志 , 2020, 26(5): 112-114. 

[8] XIAO N, MA H M, GAO H, et al. Structurefunction crosstalk in liver cancer research: protein structuromics[J]. Int J Biol Macromol, 2023, 244: 125291. 

[9] Muñoz-Martínez S, Sapena V, Forner A, et al. Assessing the impact of COVID-19 on liver cancer management (CERO-19)[J]. JHEP Rep, 2021, 3(3): 100260. 

[10] 朱文英 , 江园 , 刘雪 . 临床护理路径在肝癌介入治 疗患者术后护理中的应用效果分析 [J]. 吉林医学 , 2020, 41(3): 730-731. 

[11] 冯娜 , 杭秦雯 . 临床护理路径在肝癌介入栓塞治疗 患者中的应用及效果 [J]. 当代护士 ( 中旬刊 ), 2020, 27(1): 80-83. 

[12] Nguyen A, Milley K, Druce P, et al. Surveillance for liver cancer in primary care: a systematic review of the evidence[J]. Aust J Gen Pract, 2023, 52(11): 801-807. 

[13] 白婷婷 , 蔡惠安 . 临床护理路径对肝癌介入治疗患 者围手术期肝功能的影响 [J]. 临床医学研究与实 践 , 2020, 5(24): 172-174. 

[14] 顾士菊 . 分析临床护理路径对肝癌介入治疗患者护 理满意度及生存质量的影响 [J]. 世界最新医学信息 文摘 ( 连续型电子期刊 ), 2020, 20(38): 251-252. 

[15] 田海龙 , 汤洁 . 临床护理路径对肝癌介入治疗患者 疼痛程度、生活质量及预后的影响 [J]. 国际护理学 杂志 , 2020, 39(10): 1847-1850. 

[16] 朱莉 , 曾凡 . 临床护理路径对肝癌介入治疗患者肝 功能、睡眠质量及并发症的影响 [J]. 国际护理学杂 志 , 2021, 40(12): 2222-2225. 

[17] 韦小妹 . 肝癌介入治疗中临床护理路径的应用价值 [J]. 中国保健营养 , 2020, 30(10): 224. 

[18] WANG S T, YE Z X, PAN Z Y, et al. “Shared decision making assistant”: a smartphone application to meet the decision-making needs of patients with primary liver cancer[J]. Comput Inform Nurs, 2021, 39(12): 984-991. 

[19] 乔世玲 . 不同围手术期护理干预措施对行肝癌根治 术后患者自我效能感和心理状态的影响 [J]. 中西医 结合护理 ( 中英文 ), 2021, 7(10): 124-126. 

[20] 闫凤霞 , 李红 . 基于加速康复外科理念的集束化护理 策略在原发性肝癌患者中的应用 [J]. 国际护理学杂 志 , 2022, 41(3): 497-500.