腹腔镜下膀胱切除-乙状结肠代膀胱术的护理  

Nursing for laparoscopic radical cystectomy and sigmoid colon orthotopic neobladder reconstruction in invasive bladder cancer

作　　者：杨舜兰[1] 杨燕娇[1] 杨奎秀 

机构地区：[1]广东省汕头大学医学院第二附属医院泌尿外科,汕头市515041

出　　处：《护理实践与研究》2014年第1期27-29,共3页Nursing Practice and Research

摘　　要：目的：探讨腹腔镜根治性膀胱切除-乙状结肠原位新膀胱术治疗浸润性膀胱癌的护理方法.方法：对18例浸润性膀胱癌患者在术前做好心理护理、术前宣教和肠道准备,术后严密观察病情、做好各引流管的护理和并发症的观察与处理,以及指导患者定时排尿和进行盆底肌的训练.结果：18例患者手术成功,患者恢复良好,术后5～7d恢复饮食,2周后拔除盆腔引流管,3～4周拔除膀胱造瘘管,5～6周拔除导尿管及双侧输尿管支架管.患者拔除尿管后,经过对新建膀胱进行排尿功能训练,2周后可自控排尿,仅1例患者夜间偶有尿失禁.结论：腹腔镜根治性膀胱切除-乙状结肠原位新膀胱术治疗浸润性膀胱癌,配合围术期精心护理,可提高手术成功率,减少术后并发症,减轻患者痛苦,促进患者康复.Objective：To explore the nursing methods for laparoscopic radical cystectomy and sigmoid colon orthotopic neobladder reconstruction in invasive bladder cancer, Methods：18 cases of invasive bladder cancer, do well preoperation guidance, preoperative education and bowel preparation. Strengthen the observation after the operation, do a good job of the nursing of the drainage tube and of the observation and timely treatment about complications at the same time. Besides, to guid patients urinate punctually and take pelvic floor muscle training regularly. Results：All operations were completed successfully and pa- tients recovered well. Oral intake was allowed in 5 to 7 days after operation. Pelvic cavity drainage tube was removed in 2 weeks and bladder fistula was re- moved in 3 to 4 weeks. Bilateral urteral stents and the pouch catheter were removed in 5 to 6 weeks postoperatively. After catheter removal and micturition function training for the neobladde, patients can effective for controlled micturition after 2 weeks, but only one with nocturnal incontinence. Conclusions： Laparoscopic radical cystectomy and sigmoid colon orthotopic neobladder reconstruction with less incision, cooperating with perioperative careful nursing can improve the success rate of surgery, reduce complications, relieve patients＇pain, and promote postoperative recovery.

关 键 词：腹腔镜 膀胱肿瘤 膀胱根治切除 护理 

分 类 号：R47[医药卫生—护理学]