腹膜后去分化脂肪肉瘤联合多脏器切除患者的护理

Perioperative care of patients with retroperitoneal dedifferentiated liposarcoma combined with multiple organ resection

总结2022年6月至2023年6月浙江大学医学院附属第一医院收治10例腹膜后去分化脂肪肉瘤联合多脏器切除患者围手术期护理经验。护理要点包括术前个性化运动锻炼改善心肺功能,多阶段营养干预改善营养不良,多形式心理护理缓解患者焦虑抑郁情绪,预置输尿管支架管(又称双J管)期间感染及出血风险的防范。术后动态监测血流动力学指标,防范低血容量性休克;严密观察引流管情况,早期识别肠漏、尿漏等并发症;中医药联合护理,积极干预胃瘫综合征;严密观察肾功能,防范肾脏反射性无尿。10例患者经周到细致的护理均康复出院。出院后随访3个月,患者恢复良好,能够正常饮食工作。

To summarize the perioperative nursing experience of 10 patients with retroperitoneal dedifferentiated liposarcoma combined with multiple organ resection admitted to the First Affiliated Hospital of Zhejiang University School of Medicine from June 2022 to June 2023.Nursing care points include preoperative personalized exercise to improve cardiopulmonary function,multi-stage nutritional intervention to improve malnutrition,multi-form psychological care to relieve patients'anxiety and depression,prevention of infection and bleeding risk during the pre-positioning of the double J-tube.Postoperative care includes dynamic monitoring of hemodynamic indicators to guard against hypovolemic shock,close observation of drainage tubes for early recognition of complications such as intestinal leakage and urinary leakage,active intervention in gastroparesis syndrome with traditional Chinese medicine care and guarding against renal reflex anuria.Ten patients were discharged from the hospital after thoughtful and meticulous care.After 3 months of follow-up,the patients recovered well and lived a normal life.