腹腔镜下保留自主神经广泛子宫切除加盆腔淋巴结清扫术的手术配合

Laparoscopic Surgery for the Extensive Hysterectomy and Pelvic Lymph Node Dissection

目的该课题旨在探讨子宫切除术患者行腹腔镜下保留自主神经广泛子宫切除手术与盆腔淋巴结清扫术的手术护理配合。方法回顾性分析该院2015年8月—2017年12月在院治疗的24例子宫切除术患者,对其术前和术中的护理配合作总结分析。结果该组24例子宫切除术患者成功完成手术,患者手术成功率100%,且安全返回病房,术后9~15 d康复后办理离院手续,未发生严重并发症。其手术时间4~6 h,平均(4.53±0.26)h;术中出血76~360 mL,平均(175.23±49.27)mL;住院时间9~15 d,平均(10.53±0.62)d;无术中输血病例,有2例术后输血;导尿管留置8~19 d,平均(15.02±1.98)d,导尿管拔除后都能够正常小便;术后72 h内均恢复肠功能。结论腹腔镜下保留自主神经广泛子宫切除手术是改善子宫切除术患者术后膀胱功能的有效措施,可提高患者的生存质量。结合针对性的护理配合,可保障该术与盆腔淋巴结清扫术顺利完成,提高患者治疗与护理的质量。

Objective This project aims to explore the surgical nursing cooperation of patients with hysterectomy with laparoscopic surgery for extensive hysterectomy and pelvic lymph node dissection.Methods A retrospective analysis of 24 patients with hysterectomy from August 2015 to December 2017 in the hospital was reviewed.Results In this group,24 patients with hysterectomy successfully completed the operation.The patient's success rate was 100%,and they returned to the ward safely.After 9~15 days of rehabilitation,they were discharged from the hospital and no serious complications occurred.The operation time was 4~6 h,with an average of(4.53±0.26)h;intraoperative bleeding 76-360 mL,mean(175.23±49.27)mL;hospitalization time 9~15 d,mean(10.53±0.62)d;no intraoperative blood transfusion,there were 2 cases of postoperative blood transfusion;the catheter was indwelled for 8 to 19 d,with an average of(15.02±1.98)d.The catheter was able to urinate normally after removal of the catheter;the intestinal function was restored within 72 h after surgery.Conclusion Laparoscopic preservation of autonomic abdomen extensive hysterectomy is an effective measure to improve postoperative bladder function in patients undergoing hysterectomy,and can improve the quality of life of patients.Combined with targeted nursing cooperation,the operation and pelvic lymphadenectomy can be successfully completed,and the quality of treatment and care of patients can be improved.