腹腔镜Roux-en-Y胃旁路术治疗2型糖尿病患者的护理

Perioperative Nursing of Laparoscopic Roux-en-Y Gastric Bypass Treatment on Type-2 Diabetes Mellitus Patients

目的探讨腹腔镜Roux-en-Y胃旁路术治疗2型糖尿病(type 2diabetes mellitus,T2DM)患者的护理方法。方法回顾性分析2010年6月至2011年1月在广州军区武汉总医院普通外科进行腹腔镜下Roux-en-Y胃肠旁路术治疗的12例T2DM患者的临床资料及治疗过程。所有患者均行腹腔镜Roux-en-Y胃旁路术,术前进行详细评估和准备,包括血糖控制、心理护理干预、膳食控制;术后密切观察病情、定时监测并控制血糖、加强各种管道护理、提供合理的营养支持,观察、预防并发症的发生,并注重对出院患者宣教及随访。结果本组患者均成功完成全腹腔镜下操作。患者术后2周,1、3个月及1年随访率均为100%。术后1个月随访,仅1例患者仍需使用胰岛素,但胰岛素用量从术前68U/d减少至26U/d;其他11例患者均摆脱了胰岛素及其他药物,空腹血糖恢复正常。结论腹腔镜Roux-en-Y胃旁路术治疗T2DM效果较好,精心护理是确保手术顺利进行、减少术后并发症、促进术后良好恢复的关键。

Objective To explore the nursing measures of the laparoscopic roux-en-Y gastric bypass treatment on type-2 diabetes mellitus（T2DM） patients.Methods From June 2006 to January 2011,the clinical data and treatment procedures of 12 T2DM patients with the laparoscopic roux-en-Y gastric bypass treatment were analyzed retrospectively.All the T2DM patients underwent accurate preoperative assessment and preparation,including strict blood sugar controlling,psychological nursing intervention and reasonable diet controlling as well as close observation of the illness status after operation,regular monitor of blood glucose and reasonable control blood sugar,varied strengthened pipelines nursing,reasonable nutrition support,observation and prevention of the occurrence of complications,and enhanced discharge education and follow-up.Results All the patients completed the laparoscopic roux-en-Y gastric bypass treatment.The follow-up rates at 2 weeks,1 month,3 months and 1 year after the operation were 100%.Only 1 patient needed to use insulin,but the insulin dosage was reduced from 68 U/d before the treatment to 26 U/d after the treatment.The other 11 patients were free from insulin and medications and their fasting blood glucose values went back to the normal.Conclusion The laparoscopic roux-en-Y gastric bypass treatment on type-2 diabetes mellitus patients is effective in treating T2DM.Elaborate perioperative nursing can ensure smooth operation,good postoperative recovery and fewer postoperative complications.