腹腔镜下直肠癌根治联合前列腺汽化电切术的围术期护理

Perioperative Nrsing of Laparoscopic Radical Resection of Rectal Carcinoma Combined with Electrovaporization-ablation of Prostate

目的探讨直肠癌伴前列腺增生患者腹腔镜下直肠癌根治术联合前列腺汽化电切术的围术期护理措施。方法对2006年6月至2009年12月收治的17例行腹腔镜下直肠癌根治术联合前列腺汽化电切术患者的临床资料和护理措施进行回顾性分析和总结。结果 1例患者术后出血造成膀胱填塞,立即行膀胱镜止血和血块清除术术后恢复正常;2例患者术后7d拔除尿管后发生尿潴留,经留置尿管、膀胱功能训练7d后排尿正常。17例患者的下床活动时间、排气时间、排便时间、带尿管时间、总住院天数分别为1～2、2～3、1～5、9～14、11～18d。结论对于行腹腔镜下直肠癌根治联合前列腺汽化电切一期手术的患者,术前加强心理护理、尿道护理、肠道准备和皮肤准备,术后加强生命体征和排尿的观察以及引流管、排便和腹壁造口的护理,预防泌尿道感染,对于保证手术治疗效果、减轻患者痛苦、促进患者术后康复具有重要意义。

Objective To investigate the perioperative nursing measures of laparoscopic radical resection of rectal carcinoma combined with electrovaporization-ablation of the prostate in patients suffering from rectal carcinoma and prostatic hyperplasia.Methods From June 2006 to December 2009,a retrospective study was conducted on the clinical data and corresponding nursing of 17 patients underwent laparoscopic radical resection of rectal carcinoma combined with electrovaporization-ablation of the prostate.Results One patient developed bladder filling caused by postoperative bleeding and then recovered with immediate cystoscopic hemostasis and removal of blood clots.Two paients who suffered from urinary retention at 7 d after catheter removal urinates normally with 7 d of indwelling catheter and bladder training.Of the 17 patients,the time of movement getting out of bed,exhaust defecation time,catheter time,and a total length of hospital stay were 1-2,2-3,1-5,9-14 and 11-18 d,respectively.Conclusion For patients underwent laparoscopic radical resection of rectal carcinoma combined with electrovaporization-ablation of the prostate,preoperative strengthened psychological nursing,urinary tract nursing,bowel preparation and skin preparation,postoperative life-enhancing features and voiding observation as well as drainage,nursing of bowel and abdominal wall stoma and prevention of urinary tract infection play an vital role in ensuring surgical effects,reducing patients＇ suffering and promoting the rehabilitation of patients.