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微创泌尿外科杂志  2014, Vol. 3 Issue (6): 372-376    
  护理研究 本期目录 | 过刊浏览 | 高级检索 |
30例机器人辅助腹腔镜膀胱全切、回肠膀胱术后造口患者全程护理研究
刘文杰1
1中国人民解放军总医院泌尿外科 100853 北京
Nursing research of 30 patients who had undergone the robot-assisted laparoscopic radical cystectomy and Bricker operation
Liu Wenjie1
1Department of Urology, General Hospital of PLA, Beijing 100853, China
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摘要 目的:介绍了30例机器人膀胱全切、回肠膀胱术后造口患者的全程护理体会。方法:对30例膀胱恶性肿瘤患者行机器人辅助腹腔镜膀胱全切、回肠膀胱术,观察了术前、术后护理,并发症的预防及出院延续性护理的效果。结果:22例患者平稳度过围手术期,并且能够以积圾的心态配合治疗、护理,手术成功,术后无护理并发症。1例患者术后1周出现造口回缩,2例患者术后3天出现尿液浸渍性皮炎,3例患者术后2个月复查时出现造口旁疝,其他2例患者术后1个月出现肠梗阻,二次入院保守治疗。术后出现并发症的8例患者经密切观察和积极处理,均已痊愈。其他患者经过积极的随访和术后延续性护理,所有患者均没有出现远期的并发症。结论:充分的术前准备(特别是针对机器人手术和即将成为造口人的患者的术前心理护理、造口定位和肠道准备)以及全面的术后护理,保持各引流管的通畅,尤其是术后尿流改道的腹壁造口的护理和并发症的处理,直接影响着手术的效果和患者的生活质量,而出院后积极有效的延续性护理对于减少远期并发症有一定的帮助,并对提高患者的自我护理能力和提升自信心方面起着重要的作用。
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刘文杰
关键词 机器人手术膀胱癌造口护理造口定位延续性护理    
AbstractObjective: To introduce the nursing care of 30 patients who had undergone the robot-assisted laparoscopic radical cystectomy and Bricker operation. Methods: A total of 30 patients had undergone the robot-assisted laparoscopic radical cystectomy and Bricker operation and the nursing effects of perioperative nursing care, Comprehensive prevention and continuing nursing were analysed. Results: 22 patients went through the perioperative period stably, meanwhile, they can coordinate with treatment and nursing care positively. The operation were successful with no complications; Colostomy retraction occurred to one postoperation patient after one week. Urine stains dermatitis was happened to 2 postoperation patients after 3 days; 3 postoperation patients have been found the parastomal hernia when reexamined after 2 months; 2 postoperation patients had intestinal obstruction after one month, and they had to go back to hospital again to get further conservative treatments.The 8 patients had been healed by frequent observation and positive treatments. No long-term complications happened to the other patients. Conclusions: The sufficient preparations of preoperation (especially for the patient's mental nursing before stoma operation, stoma positioning and bowel preparation) and postoperation, and keeping the drainage tube unobstructed, especially the nursing care of urinary stoma and management of complications affectted the operation effect and patient's living quality directly. Moreover, the effective continuing nursing care did great help for reducing long-term complications and it can increase the patient's self-nursing ability and confidence.
Key wordsrobot-assisted operation    bladder cancer    stoma care    stoma positioning    continuing nursing
收稿日期: 2014-09-30     
ZTFLH:  R737.14  
通讯作者: 刘文杰,lwj10108288@163.com   
引用本文:   
刘文杰. 30例机器人辅助腹腔镜膀胱全切、回肠膀胱术后造口患者全程护理研究[J]. 微创泌尿外科杂志, 2014, 3(6): 372-376.
Liu Wenjie. Nursing research of 30 patients who had undergone the robot-assisted laparoscopic radical cystectomy and Bricker operation. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2014, 3(6): 372-376.
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