单期多通道经皮肾镜取石术的围手术期护理

Perioperative nursing of patients undergoing one phase and multi-tract percutaneous nephrolithotomy for large complicate calculi

目的:总结单期多通道经皮肾镜取石术治疗复杂性肾结石患者围手术期的临床护理体会。方法:回顾性分析2005年3月～2010年3月在我院应用单期多通道经皮肾镜取石术及气压弹道碎石术治疗复杂性肾结石98例患者术前、术中及术后的护理体会。结果:经围手术期的精心护理,98例患者均成功单期取石,其中双通道91例,三通道7例。结石清除率86.2%,平均手术时间92.5 min。肾造瘘管平均留置7 d,术后平均住院9.6 d。所有患者未发生严重并发症,均顺利康复出院。结论:单期多通道经皮肾镜取石术围手术期护理有一定的特殊性,术前充分准备,细致耐心的心理护理,术中医师、护士和患者的密切配合,术后做好管道护理,严密观察生命体征和并发症,是患者治疗成功的关键因素。

Objective：To investigate the nursing experience of patients suffer from complicate renal calculi and need undergoing one phase - multi - tract percutaneous nephrolithotomy. Methods：Nurse experience was analyzed retrospectively on 98 patients with complex renal calculi from March 2005 to March 2010 received one phase-multi -tract peroutaneous nephrolithotrlpsy. Results：All the cases was successfully lithotripted. In these 98 eases,91 patients were treated with two - channel PCNL and 7 patients with three - channel PCNL with the mean operative period of 92.5 min, and the total stone clearance was 86.2%. There were no critical complications in all the patients, such hemorrhage, serious infections, injury of coelorgans, and so on. Conclusion ： One phase - multi - tract pereutaneous nephrolithotomy is a kind of special operation, which needs careful nurse around the operative period. Well catheter nurseing and close observation after surgery to prevent the complications play key roles for the recovery.