经皮肾造瘘术治疗尿脓毒血症患者感染状态的监测与护理

Observation and nursing of infection state of urosepsis with percutaneous nephrostomy

目的探讨尿脓毒血症需行经皮肾造瘘术患者的护理要点。方法回顾性分析58例行经皮肾造瘘术治疗的尿脓毒血症患者,给予心理护理、及穿刺前后病情动态观察、体温监测、早期液体复苏及血管活性药物应用的护理、控制感染的护理以及经皮肾造瘘术后护理。结果 57例患者成功行经皮肾造瘘术,1例患者因穿刺失败改行输尿管内支架管置入术;1例患者因并发DIC抢救无效死亡,3例患者因无法解除梗阻需长期留置引流管,余患者均解除梗阻后康复出院。结论经皮肾造瘘术治疗梗阻引起的尿脓毒血症安全有效,医护人员密切合作是挽救尿脓毒血症患者生命的基础。专科护理人员应熟知病情变化,缓解患者的紧张情绪,取得满意的治疗效果。

Objective To explore the main points of nursing care in patients with urosepsis who requiring percutaneous nephrostomy （PCN）. Method Clinical data of 58 urosepsis with PCN were analyzed retrospectively, to summarize the nurs- ing essentials include： mental nursing, dynamic observation before and after PCN, temperature monitoring, early rapid fluid re- suscitation and vasopressor therapy nursing, antimicrobial therapy nursing, the nursing of PCN. Result Fifty seven patients underwent PCN and 1 patient underwent retrograde stent insertion because failure of PCN, 1 patient died of DIC, because of advanced malignant tumor 3 patients with permanent drainage. With treatment and nursing care, the others recovered and dis- charged after average 3 months. Conclusion PCN is associated with minimal morbidity and provides therapeutic benefit, and collaboration between medical personnels is essential to ensure get good results. Morevoer nursing staff should understand the clinical manifestation of urosepsis, alleviate patients intense sentiment, to promote the patient soon to be restored to health.