4例腹腔镜根治性膀胱全切原位回肠新膀胱围手术期护理

Peri-operative care of laparoscopic radical cystectomy ileal neobladder

目的:探讨腹腔镜下全膀胱切除原位回肠新膀胱术前术后的护理措施及如何减少术后并发症的发生。方法:总结回顾分析4例腹腔镜下原位回肠新膀胱术的护理资料。结果:4例患者术后22～24d拔除尿管,术后早期均有不同程度的尿失禁,以夜间较明显。但经过训练后,除1例女性患者外,其余患者约在术后4～6周尿控均达到满意的程度。而该女性患者在术后3个月白天能基本实现尿控,夜间仍有尿失禁。结论:腹腔镜下全膀胱切除原位回肠新膀胱术具有创伤小、出血少、术后恢复快的优点,能明显改善患者的生活质量。术前心理护理及术后回肠新膀胱排尿功能的训练是减少并发症的关键。

Objective：To detect the peri-operative care of laparoscopic radical cystectomy ileal neobladder,how to reduce the postoperative complications.Methods：Summarized and analysed the data of 4 cases undergone laparoscopic radical cystectomy ileal neobladder.Results：The catheters were removed after 22-24 day of operations.In early period,different degree of incontinence occurred,especially during night.Except a female patient,the others could micturate well after 4-6 weeks of operations.The female patient can almost control urination by daylight after 3 months operation,but still incontinence during night.Conclusion：Laparoscopic radical cystectomy ileal neobladder had the advantages of minimal invasion,less bleeding and quicker recovery,could improve the quality of patients’ life.Pre-operation psychological care and post-operation training of urination were the key of reducing the complications.