经皮肾穿刺微造瘘气压弹道碎石术治疗复杂性肾结石的围术期护理

Perioperative nursing of minimally invasive percutaneous nephrolithotomy in treatment of complex renal calculi

目的:探讨经皮肾穿刺微造瘘气压弹道碎石术(MPCNL)治疗复杂性肾结石的围术期的护理。方法:对52例经皮肾穿刺微造瘘气压弹道碎石术患者给予围术期专科护理。结果:Ⅰ期穿刺成功52例(100%),本组患者46例Ⅰ期手术成功取石,2例需行Ⅱ期取石,2例辅以体外冲击波碎石(ESWL),2例残留小结石。术后3～6个月结石排石率为52例(100%)。手术时间为72～130 min。平均住院时间为10 d,术中出血1例,术后大出血1例,2例术后由于过早活动而引起出血。结论:经皮肾穿刺微造瘘气压弹道碎石术围术期护理有一定的特殊性和严密性,术前心理护理,充分的术前准备,术后的病情观察,管道护理及出院指导是保证手术成功和患者顺利康复的重要措施,值得进一步探讨推广。

Objective： To investigate the perioperative nursing of minimally invasive percutaneous nephrolithotomy（MPCNL） in the treatment of complex renal calculi.Methods： 52 patients having received MPCNL were given perioperative specialist nursing care.Results： There were 52 patients succeed of phase I puncture.46 patients received successful phase I surgery,2 required phase II surgery,2 received combined ESWL and 2 had residual small stones.The calculi excretion rate 3 to 6 months after surgery was 100%,the operation time was 72-130 minutes and the average length of stay was 10 days.Intraoperative haemorrhage appeared in 1 patient and postoperative massive haemorrhage in 1 patient.2 cases of postoperative haemorrhage were caused by premature activity.Conclusion： Nursing care of MPCNL has certain specificity and precision.Preoperative mental nursing,adequate preoperative preparation,postoperative observation of conditions,nursing care and discharge guide are important measures to ensure successful surgery and recovery,thereby worthy of further exploration and promotion.