复杂性肾结石经皮肾穿刺造瘘肾镜碎石清石系统治疗的护理

Nurse of complex renal calculi under percutaneous nephrolithotomy with ultrasonic and pneumatic lithotriptor

目的探讨经皮肾镜下应用第3代弹道超声波碎石清石系统治疗112例复杂性肾结石患者的临床效果和护理体会。方法总结分析于2007年3月至2008年2月在本院应用经皮肾镜气压弹道碎石术(PCNL),结合最先进的第3代弹道超声波碎石清石系统治疗复杂性肾结石112例患者的临床资料和护理体会。结果112例患者均成功Ⅰ期取石,6例行Ⅱ期PCNL清石。结石清除率91.1%,平均手术时间90.4min。肾造瘘管平均留置时间7d,术后平均住院时间10d。术后大出血1例。结论经皮肾镜超声气压弹道碎石术围手术期护理有一定的特殊性和严密性,术前充分准备,细致耐心的心理护理,术中医生、护士和患者本人的密切配合,术后做好管道护理,严密观察生命体征和并发症,是治疗肾结石患者成功的基础和关键。

Objective To investigate the nurse of percutaneous nephrolithotomy with ultrasonic and pneumatic lithotripter for 112 cases with complex renal caculi. Methods Nurse experience was analyzed retrospectively on 112 patients with complex renal calculi from March 2007 to February 2008 received percutaneous nephrolithotripsy using a EMS Ⅲ pneumatic and ultrasonic lithotripter. Results All the 112 cases was successfully lithotripted,with the mean operative period of 90.4 min,6 cases received second-stage lithotripsy,and the total stone clearance was 91.1%. 1 case endured gross hematuria. Conclusion Percutaneous nephrolithotomy is a kind of special operation,which needs careful nurse around the operative period, Well catheter nurseing and close observation after surgery to prevent the complications play key roles for the recovery.