不同碎石术治疗膀胱结石的围手术期护理体会

The Clinical Curative Effect Analysis and Nursing Experience in the Treatment of bladder calculi by Pyeloscopy Holmium Laser Lithotripsy Assisted with Modified Resectoscope Sheath

目的:对比并总结改良型电切镜鞘辅助肾镜钬激光碎石术与普通肾镜钬激光碎石术两种方法治疗膀胱结石的临床疗效和围手术期护理体会。方法:对膀胱结石患者168例分别采用改良型电切镜鞘辅助肾镜钬激光碎石术(即改良组84例)和普通肾镜钬激光碎石术(即传统组84例)进行碎石治疗,对比和评价两种术式的临床疗效和围手术期护理方法。结果:改良组碎石时间、术中失血量、膀胱冲洗时间、导尿管留置时间、住院时间、膀胱黏膜损伤率低于传统组,一次碎石成功率方面高于传统组,两组比较差异均有统计学意义(P<0.05)。结论:改良型电切镜鞘辅助肾镜钬激光碎石术是一种安全、创伤小、术后恢复快的治疗膀胱结石的改良术式,护理人员良好的术前护理准备、术中护理配合、术后及出院指导则是手术顺利完成的重要保证。

Objectives:To evaluate the clinical curative effects of common pyeloscopy holmium laser lithotripsy assisted with modified resectoscope sheath on urinary bladder calculi and to summarize the nursing experience related to the modified method.Methods:168patients with bladder calculi had been divided into 2groups,84patients in the modified group with common pyeloscopy holmium laser lithotripsy assisted with modified resectoscope sheath and 84patients in the common group with common pyeloscopy holmium laser lithotripsy.Then the clinical curative effects between two groups had been compared and the nursing experience related to the modified method had been explored.Results:The curative effects in the modified group were obviously better than the common group with less lithotripsy time,less blood loss volume during surgery,less continuous bladder irrigation time,less catheter residence time,less hospitalization days and lower bladder mucosal damage rate,while the modified group was obviously better than the common group in the success rate of lithotripsy on one session(P<0.05).Conclusion:The pyeloscopy holmium laser lithotripsy assisted with modified resectoscope sheath is a safe modified method with small trauma and speedy recovery for treatment of bladder calculi while good preoperative nursing preparation,nursing assistance during operation and postoperative guidance are important guarantees for the smooth completion of the modified method.