18例肾结石行输尿管镜钬激光碎石术后液体外渗的观察与护理

Observation and nursing of fluid extravasation in 18 patients with kidney calculi after reteroscopic holmium laser lithotripsy

报告了18例肾结石行输尿管镜钬激光碎石术后液体外渗的观察与护理。本组12例发生单纯肾周积液,主要表现为腰部胀痛不适;3例肾周积液合并腹腔积液,出现腹膜刺激征;1例肾周积液合并胸腹腔积液,表现有呼吸困难;2例单纯水中毒,其中1例谵语,另1例躁动不安。本组均有不同程度发热,经及时观察和处理,均恢复顺利。认为应密切观察患者意识、疼痛部位,重视患者主诉,监测体温、呼吸、血压、中心静脉压、电解质情况,积极配合治疗并采取相应护理措施,确保患者顺利恢复。

This paper introduces the observation and nursing of fluid extravasation in 18 patients with kidney calculi after ureteroscopic holmium laser lithotripsy.Among the patients with fluid extravasation,twelve cases with simple perirenal effusion suffered from waist pain,three cases with perirenal effusion complicated with ascites suffered from peritoneal irritation,one case with perirenal effusion complicated with pleural and abdominal effusion suffered from dyspnea,two cases with water intoxication showed delirium and restlessness,respectively.All the cases suffered from fever and recovered well after intensive treatment and nursing.It is emphasized that the key points to promote patient recovery were close observation of patients＇ consciousness and location of pain,concerning patients＇ complaints,monitoring vital signs and central venous pressure,and taking proper measures timely.