45例膀胱癌手术患者的系统化临床护理并资料分析

Systematic clinical nursing in 45 patients with bladder cancer

目的回顾性分析45例行膀胱全切、回肠代膀胱手术的膀胱癌患者的临床护理资料,总结护理经验,提高手术质量。方法对45例膀胱全切、回肠代膀胱术患者实施术前肠道准备、心理护理、术后密切观察、围管道护理、尿道造口护理、积极预防并发症、促进新膀胱功能训练等护理措施,观察护理措施的实施效果。结果 45例患者均安全度过围术期,其中发生尿失禁6例,发生率13.33%,经调试后均能自主排尿;随访8个月,发生慢性尿潴留3例,占6.67%,发生新膀胱输尿管反流1例,占2.22%,无感染病例发生。结论充分的术前准备、术后密切观察与护理、做好术后管道的护理与新膀胱功能训练是预防和减少膀胱癌术后并发症、提高患者生存质量和自理能力的必要和有效的措施。

Objective To retrospectively review the clinical nursing data of 45 patients with bladder cancer who underwent radical cystectomy and ileal neobladder operation,sum up nursing experience,and improve operation quality.Methods Forty-five patients with bladder cancer who underwent radical cystectomy and ileal neobladder operation were included in the study.Perioperative bowel preparation,psychological nursing,close postoperative observation of peripipeline nursing,urethral stoma care,prevention of complications,and function training of new bladder were implemented.The clinical nursing effects were observed thereafter.Results All 45 patients went through perioperative period.Among them,6 patients had urinary incontinence,with an incidence rate of 13.33％.After debugging,all patients could urinate independently.During followup of 8 months,3 patients had chronic urinary retention （6.67 ％）.One patient had new vesicoureteral reflux （2.22 ％）.No infection was observed.Conclusion Sufficient preoperative preparation,close postoperative observation,application of new bladder function training,and peripipeline nursing after operation are necessary and effective measures to prevent and reduce postoperative complications,improve life quality of patients with bladder cancer who receive radical cystectomy and ileal neobladder operation.