介入治疗PCNL后迟发性出血的全程护理研究

Nursing Care in the Whole Process of the Interventional Treatment of Late Hemorrhage after Percutaneous Nephrolithotomy Lithotripsy(PCNL)

目的研究介入治疗经皮肾镜碎石术（PCNL）后迟发性出血的全程护理效果,以便为其介入治疗的临床护理提供依据。方法选取2012年1月至2014年10月在成都医学院第一附属医院接受介入治疗的PCNL后迟发性出血患者38例,行术前、术中和术后护理,预防并发症,并行出院指导等全程护理,观察导尿管、造瘘管引流液和术后并发症等情况。结果所有患者介入治疗均无异常,术后2~5d导尿管、造瘘管均无鲜红引流液出现,未见再出血患者。复查红细胞压积、血红蛋白,均未见进行性降低,也未发生穿刺点出血、穿刺点周围血肿、肺部感染、压疮、栓塞综合征和感染等术后并发症。患者术后5~7d康复出院。结论全程护理可有效提高手术成功率,降低术后并发症发病率,同时能有效促进患者康复。

Objective To study the nursing care in the whole process of the interventional treatment of late hemorrhage after percutaneous nephrolithotomy lithotripsy（PCNL）. Methods The 38 patients received intervention treatment of late-onset hemorrhage after PCNL from January 2012 to October 2014 in our hospital were studied. The preoperative care,intraoperative care and postoperative nursing, prevention of complications, and discharge guidance were compared including the whole nursing, observation of catheter and fistula drainage fluid, postoperative complications and other indicators. Results All patients with interventional therapy were no abnormalities,2-5 days after catheter or fistula, there were no red liquid drainage, and further hemorrhage. Hematology showed that there were no progressive lower hemoglobin and hematocrit. The bleeding puncture point, puncture point around the hematoma, pulmonary infection, pressure sores, embolism syndrome, postoperative complications such as infection were not evident. The patients were discharged from hospital after 5-7 days postoperative rehabilitation. Conclusion The whole process nursing can not only effectively improve the success rate of surgery, reduce the incidence of postoperative complications,but also can effectively promote the patient recover,and improve patient satisfaction.