腹膜外入路经脐单孔腹腔镜前列腺癌根治术围手术期护理:附11例报告

Perioperative nursing of extraperitoneal transumbilical single-port laparo-endoscopic radical pros-tatectomy:Report of 11 cases

目的报道使用自制多通道套管经脐切口行单孔腹腔镜前列腺根治性切除术护理体会。方法 2009年8月至2010年3月,对11例局限性前列腺癌患者行单孔腹腔镜下前列腺根治性切除术,配合围手术期的各项处理。观察术后手术切口护理、管道护理、疼痛评估、控尿训练的效果。结果 11例手术均顺利完成,1例术后膀胱尿道吻合口漏,2例淋巴漏,1例泌尿系感染,经保守治疗治愈。患者术后第3天平均疼痛评分为1.5/10(0～5)。5例尿失禁观察6个月恢复完全控尿。结论做好围术期护理,特别是术前心理护理、肠道准备和术后管道护理,控尿训练对确保手术的成功,提高患者的自理能力和生存质量起着重要的作用。

Objective To explore the perioperative nursing methods of extraperitoneal transumbilical single-port laparo-endoscopic radical prostatectomy. Methods From August 2009 to March 2010, 11 patients with local prostate carcinoma were performed extraperitoneal transumhilical single-port laparo-endoscopic radical prostatectomy, with the treatment of perioperative, incision care, pipe care, pain assessment and the effect of urination assessment and rehabilitation training were recorded. Results Totally 11 operative procedures were successfully performed. One case had vesicourethral fistula, two cases had lymphatic fistula and one case had urinary infection, and were healed with reservative treatment. 3 days after surgery in patients with average pain score was 1.5/10 （0 - 5）. 5 cases with postoperative incontinence recovered completely 6 months after operation by rehabilitation training. Conclusion Perioperative nursing, especially preoperative psychological care, bowel preparation and postoperative drainage tube management, play critical roles on the success of operation, improvement of self-care ability and the life quality of the patients.