非阴茎手术患者在麻醉手术期间的阴茎管理

Management strategy for nursing care of penis of patients during anesthesia assisted non-penile surgery

目的探讨非阴茎手术患者在麻醉手术期间的阴茎管理策略。方法收集2017年1月-2018年12月手术室于麻醉下行非阴茎手术患者中发生阴茎相关不良事件及损伤的患者9例,结合其临床资料对阴茎损伤的病因、防范策略和处理进行分析总结。结果体位摆放不当、导尿管相关损伤和经尿道手术操作不当是引起非阴茎手术患者麻醉手术期间阴茎损伤的主要原因。预防策略主要为:摆放体位时不牵拉、挤压、折弯阴茎;在行导尿操作时,动作轻柔不使用暴力,务必将尿道管气囊送入膀胱后再充注气囊,留置导尿后妥善固定导尿管;在经尿道手术操作时,尽可能在直视、视野清晰下操作,术中如发生阴茎勃起,则需采用阶梯式方法进行处理,使阴茎萎软后再继续操作。结论针对非阴茎手术患者在麻醉手术期间的阴茎管理,需树立全过程、全方位管理的理念,在充分掌握可能引起术中阴茎损伤病因的基础上,对患者的阴茎进行科学的程序化管理,以维护患者的阴茎健康。

Objective To formulate a scientific management strategy for nursing care of penis of patients during anesthesia assisted non-penile surgery. Methods Firstly, the clinical data on the adverse events and injuries resulting from anesthesia assisted non-penile surgeries on 9 patients subjected to surgeries conducted during the period from Jan., 2017 to Dec., 2018 were collected, and then subjected to analysis so as to understand the causes, prevention measures and treatments of the events and injuries in light of relevant clinical data. Results Incorrect posture, injuries engendered by catheterization, and improperly conducted transurethral surgery were the main causes of penis injury resulting from anesthesia assisted surgery. Prevention strategies include the following. During the process of repositioning the body of the patient, any action that may lead to stretching, compressing and bending the penis should be avoided. Catheterization must be conducted gently and carefully. The air-bulb of urinary catheter must not be inflated until after it has been completely and properly placed in the bladder. The catheter needs to be properly held in position after it has been placed. Trans-urethral surgery should be operated under direct and clear vision. In case of abnormal intraoperative penile erection, detumescent Methods should be used to limp the penis before surgery continues. Conclusions During the process of anesthesia assisted non-penile surgery the practice of nursing care of the penis of the patients should be informed with comprehensive and whole-process management. Adequate knowledge of the causes of penis injury is needed in order to formulate scientific procedures for nursing care and hence the health of the penis of the patients.