后腹腔镜保留肾单位手术围手术期护理体会

Nursing experience during the perioperation period of retroperitoneal laparoscopic nephron sparing surgery

目的探讨后腹腔镜保留肾单位手术围手术期护理体会。方法回顾性分析2010年1月至2014年12月我院泌尿外科收治的76例行后腹腔镜保留肾单位手术患者临床资料,并总结其护理经验,制定标准护理操作流程。结果 76例患者均安全度过围手术期。5例发生尿瘘,4例出现短暂性肾功能不全,其中包括2例双侧肾癌患者,2例经积极治疗后均恢复正常,未发生术后出血,且所有患者顺利出院。随访1~5年,患侧肾脏无一例肿瘤局部复发。结论精心的围手术期专科护理、标准的护理操作流程和详细的出院指导,不仅提高手术成功率,降低术后并发症,而且还提高患者术后生存质量,并保存肾功能。

Objective To explore nursing experience during the perioperation period of retroperitoneal laparoscopic nephron sparing surgery(LNSS). Methods The clinical data of 76 cases undergoing LNSS from January 2010 to December 2014 were retrospectively analyzed. The experience of clinical nursing was summarized, and standard operation procedures of nursing were established. Results The 76 patients were safe during perioperation period. Urinary fistula occurred in 5 cases, and transient renal insufficiency occurred in 4 cases, including 2 cases with bilateral renal cell carcinoma. The two cases were cured after active treatment and were all discharged smoothly, without postoperative bleeding. During the follow-up period of 1 year to 5 years, there was no local recurrence of tumor. Conclusion Careful nursing in perioperation period, standard operation procedures of nursing, and detailed guidance for discharge can improve the success rate of operation, reduce the postoperative complications, and improve the quality of life and preserve renal function.