输尿管软镜联合经皮肾镜治疗复杂性肾结石患者的护理  

Nursing Cooperation in Endoscopic Combined Intra-Renal Surgery(ECIRS)for Complex Renal Calculi

作　　者：宋丽[1] 孙颖浩[1] 杨波[1] 彭泳涵[1] 盛夏[1] 

机构地区：[1]第二军医大学长海医院泌尿外科中心,上海200433

出　　处：《解放军护理杂志》2014年第13期35-36,39,共3页Nursing Journal of Chinese People's Liberation Army

摘　　要：目的总结输尿管软镜联合经皮肾镜（endoscopic combined intra—renal surgery，ECIRS）治疗复杂性肾结石患者中的护理要点。方法回顾性分析2009年9月至2012年4月，在长海医院泌尿外科中心接受了输尿管软镜联合经皮肾镜治疗的32例复杂性肾结石患者的临床资料，总结了术前护理准备、术中配合以及术后仪器设备的清洗保养消毒等经验。结果所有患者均成功建立经皮肾镜通道，手术时间为56～170min，平均（75±20．5）min；术中出血30~210ml，平均（90±30．7）ml。所有患者均顺利实施手术，术中无大出血，无周围器官损伤，未发生肾盂穿孔等严重并发症。患者术后住院天数为4～7d，平均（5±1．2）d。结石最大直径4．8cm，平均（2．2±0．9）cm。有2例患者（6．25％）出现术后发热（体温〉38℃），经抗感染治疗后患者痊愈出院。结论术前掌握经皮肾镜和输尿管软镜等器械的特点，熟练手术操作步骤，术中与术者良好的沟通，是保证手术成功的关键。Objective To explore and evaluate the nursing cooperation in Endoscopic Combined Intra- Renal Surgery （ECIRS） for complex renal calculi.Methods Clinical data of 32 patients with complex renal calculi accepted ECIRS were reviewed retrospectively. Special preoperative care, intraoperative cooperation and cleaning and maintenance of instruments postoperatively were concluded. Results All patients were successfully had percutaneous nephrolithotomy, and the average operative time was 56--170 minutes, （75 ± 20.5） min averagely, 30 -- 210ml intraoperative bleeding, （90 ± 30.7） ml averagely. Stone fragment was successful in all patients with no intraoperative bleeding, no nearby organs damage and no complications occurrance. Postoperative inpatient days were 4--7days, （5 ± 1.2）d averagely. The average diameter of the stone was 4.8 cm, （2.2± 0.9） cm averagely.2 patients （6.25 % ） with postoperative fever （body temperature 〉 38 ℃ ）, and they were cured and discharged after anti-infective therapy.Conclusion Familiar with endoscopic instruments and procedures preoperatively, and good communication with operators intraoperatively are key points to ensure success of the surgery.

关 键 词：结合内镜 经皮肾镜 复杂性肾结石 手术配合 

分 类 号：R473.6[医药卫生—护理学] R692.4[医药卫生—临床医学]