微创经皮肾镜取石术治疗28例孤独肾结石患者的护理

目的探讨微创经皮肾镜治疗孤独肾结石患者的护理要点。方法回顾性分析总结2007年3月～2008年7月在本科室行微创经皮肾镜治疗孤独肾结石的28例患者的临床资料。结果本组28例患者手术均成功,一期单通道取石16例,一期双通道取石12例。3例患者术后存在反复出血,经高选择性肾动脉栓塞止血后治愈;2例术后当天出现寒颤、高热、血压下降等症状,经抗感染性休克治疗后治愈。结论微创经皮肾镜取石术是一种创伤小、并发症少、有效的治疗孤独肾结石的方法。护理上做好心理护理、术前体位训练、术后引流管的护理及完善健康指导是手术成功的重要保证。

Objective To investigate the nursing principle of solitary kidney calculi managed with minimally invasive pereutaneous nephrolithotomy （MPCNL）. Method The clinical data of 28 patients undergoing MPCNL in our hospital from March 2007 to June 2008 were analyzed retrospectively. Results All 28 patients underwent MPCNL successfully with kidney stones in 16 patients removed via single tract, and those in 12 patients via two tracts. 3 patients developed with recurrent bleeding after operation, and were recovered after super selective renal artery embolization. 2 patients presented shivering, high fever, and drop of postoperative blood pressure, and were managed successfully by antibiotic and anti-shock treatment. Conclusions MPCNL is an effective method to manage solitary kidney calculi for it has tremendous advantages, such as minimal renal trauma and minimal complication. When it comes to nursing care, it is important to nurse the patients circumspectively during operation, to guide the patients to practice the prone position, observe and nurse the complication of hemorrhage and infective shock closely so that the patients get recovered more smoothly.