高龄膀胱癌腹腔镜根治术患者围手术期的护理

Perioperative nursing of patients older than 75 years with bladder cancer with laparoscopic radical cystectomy

目的分析高龄腹腔镜膀胱癌根治术围手术期的护理效果，为此类患者的护理干预提供依据。方法纳入2010年1月至2015年7月于我院行腹腔镜膀胱癌根治术且年龄在75岁以上的患者43例，对其临床资料进行回顾性分析，总结其围术期护理经验。结果年龄75～84岁，中位年龄78岁；患者术后恢复进食平均时间（3．57±2．31）d、下床活动时间（5．40±1．73）d、术后平均住院天数（12．71±1．18）d，以及术后麻醉性止痛剂用量（27．62±9．33）mg。早期主要并发症包括：不全性肠梗阻，肺部感染、肾盂肾炎、肾积水以及深静脉血栓，均对症治疗后好转，顺利康复出院。另外，快速肠道康复方案与常规肠道准备比较短期结果无显著差异。结论围手术期精心的护理工作，不仅可以促进患者术后恢复，还可以降低高龄腹腔镜膀胱癌根治术患者术后并发症发生。

Objective To explore the perioperative nursing methods for elderly patients （≥75 years） with bladder cancer undergoing laparoscopic radical cystectomy. Methods Clinical data of 43 patients older than 75 years with bladder cancer undergoing laparoseopic radical cystectomy from January,2010 to July,2015 were retrospectively analyzed. Results 43 patients were included with a median age of 79 years. The mean time to resumption of oral intake was 3.57 ± 2.31 days. The mean time for postoperative activity was 5.40 ± 1.73 days. The mean postoperative length of stay was 12.71±1.18 days. The mean analgesic requirement was 27.62 ± 9.33 mg. Early stage postoperative complications included incomplete ileus, pulmonary infection, pyelonephritis, hydronephrosis and deep venous thrombosis. All the patients suffered from postoperative complications were cured and discharged with rigorous perioperative nursing care. Conclusion The careful nursing in perioperation of laparoscopic radical cystectomy for elderly patients not only promote postoperative recovery, but also avoid adverse events.