动脉栓塞术治疗膀胱癌伴出血的围手术期护理

Perioperative nursing of arterial embolization for the treatment of hematuria secondary to bladder carcinoma

目的探索经导管行动脉栓塞术治疗膀胱癌伴出血的围手术期处理措施。方法回顾性分析我科接受经导管行膀胱动脉栓塞术的22例膀胱癌伴出血患者的临床资料。其中19例患者伴发心脑血管疾病,3例患者伴发慢性肾功能不全。围手术期给予开展健康教育,指导肢体训练以配合手术;保持导尿通畅并记录观察血尿性质与量的改变;3例慢性肾功能不全患者,术后24h内给予血液透析。结果22例患者在栓塞技术上均成功,术中患者均能配合手术治疗。血尿在术后48h消失(18例)或明显缓解(4例)。围手术期内无严重并发症发生。结论患者在膀胱动脉栓塞术的围手术期内加强护理观察与处理,有助于膀胱动脉栓塞术的安全性和有效性。

Objective The aim of this study was to explore the perioperative management of trans-catheter arterial embolization for the treatment of gross hematuria secondary to bladder carcinoma.Methods A retrospective study was performed between September 2015 and October 2019 on 22 patients with gross hematuria secondary to bladder carcinoma underwent arterial embolization.Nineteen patients had pulmonary or cardiovascular comorbidities and 3 patients had chronic renal insufficiency.The perioperative managements included health instruction education,physical exercise training,and keeping the catheterization smooth and recording the changes in the nature and quantity of hematuria.Hemodialysis was performed for the 3 patients with chronic renal insufficiency within 24 hours after embolization.Results Arterial embolization was achieved successfully in all the 22 patients.All patients were able to cooperate with embolization procedure.Cessation or relief of gross hematuria was observed in 18 and 4 patients within 48 hours postembolization,respectively.There were no major complications during the perioperative period.Conclusion Perioperative nursing including observation and treatment is helpful for the safety and efficacy of vesical arterial embolization.