腹腔镜全直肠系膜切除术保肛治疗直肠癌围术期护理研究

Research on perioperative nursing for patients with rectal cancer treated with laparoscopic total mesorectal excision

目的总结经腹腔镜全直肠系膜切除术（LTME）治疗直肠癌的护理方法。方法25例行LTME患者做好术前心理护理、护理评估、肠道及皮肤准备，术后做好病情观察、呼吸道护理、饮食护理、体位护理、心理护理、肛周皮肤护理并指导肛门括约肌功能锻炼。结果25例手术患者手术顺利，无中转开腹，术毕均安全返回病房，术后24h可下床活动，24～48h肠道通气恢复，出院时生活完全自理，患者生活质量均良好，无1例发生护理并发症。结论通过精心、细致、有效的围术期护理，密切的病情观察使治疗达到良好的效果，可有效减少并发症发生，减轻术后不适，促进患者康复，提高患者术后生活质量。

Objective To summarize the nursing method of treatment of rectal cancer with laparoscopic total mesorectal excision （LTME） . Methods Twenty -five patients with LTME were treated with preoperative psychological care, nursing assessment, bowel and skin preparation, postoperative condition observation , respiratory care, diet care, postural care, psychological care, skin care and guidance of perianal anal sphincter exercises. Results The operations of 25 patients were well. All the patients returned the ward safely, got out of bed after 24h, and 24 ~ 48h restored intestinal ventilation. They had the ability of self - care completely, quality of life was good and no complications occurred. Conclusions Careful, meticulous, and effective perioperative nursing and close condition observation can reduce the occurrence of complications and relieve postoperative discomfort, promote the rehabilitation of patients and improve patients＇quality of life.