加速康复外科理念在达芬奇机器人辅助下行前列腺癌根治术的护理体会

Nursing experience of enhanced recovery after surgery in radical prostatectomy assisted by Da Vinci robot

随着人口老龄化及生活方式的不断改变,前列腺癌的发病率也呈逐年上升的趋势,此类患者多有年龄大、基础疾病多、心理负担重、术后康复慢等问题。本文运用加速康复外科(ERAS)理念对患者实施个性化心理护理,在术前、术后及居家康复随访过程中进行心理护理干预。在术前教会并告知患者术后并发症的预防及盆底肌功能锻炼方法;在术后加强对留置管道观察和护理,尤其对尿漏、尿路感染的护理观察;在出院后进行居家电话康复随访,根据患者尿失禁情况,进行有效的沟通和康复指导。患者出院后2个月患者精神状态良好,能回归社会工作。结果表明ERAS规范化的护理方案,在达芬奇机器人辅助下行前列腺癌根治术的围术期中,能有效地加速患者康复,减轻患者痛苦及缩短住院天数,可为临床护理提供参考。

As the population ages and lifestyles change, the incidence of prostate cancer is increasing year by year. A lot of these patients are old, with basic diseases, heavy psychological burden, slow postoperative rehabilitation, etc. In this paper, the concept of enhanced recovery after surgery (ERAS) was used to carry out individualized psychological nursing for patients. Psychological nursing intervention was carried out before and after operation and during home rehabilitation follow-up. Before operation, the prevention of postoperative complications and pelvic floor muscle function exercise were taught and informed. After the operation, the observation and nursing of indwelling tubes, especially the nursing observation of urinary leakage and urinary tract infection, were strengthened. After discharge, the patients were followed up by telephone for their rehabilitation at home, and effective communication and rehabilitation guidance were carried out according to their urinary incontinence. Two months after discharge, the patient was in good mental state and could return to social work. The results shows that the standardized nursing scheme of ERAS in the perioperative period of radical prostatectomy assisted by Da Vinci robot can effectively accelerate the patients' recovery, reduce their pain and hospital stay, which can provide references for clinical nursing.