经皮肾输尿管镜治疗复杂肾结石围手术期护理.docVIP

经皮肾输尿管镜治疗复杂肾结石围手术期护理 　【关键词】 经皮肾穿刺 摘要：目的：总结经皮肾输尿管镜治疗复杂肾结石的护理措施的经验，探讨有效的方法。方法：采取加强术前心理护理及术前准备，术后出血观察及护理，保持引流管道通畅，预防感染，做好出院指导等护理措施是保证治疗成功关键。结果：38例复杂肾结石患者手术均获成功，结石一期取净28例（73.1%），5～7d后二期取净6例（15.7%），其余4例二期取石后经ESWL治疗后排空。38例病人平均住院8.7d，术后平均住院5.5d。术中术后均未出现严重并发症。结论:术前充分准备和必要的心理护理为手术成功奠定良好的基础，术后实施有针对性护理措施，有效地预防并发症的发生，使病人顺利度过围手术期。 　　关键词： 经皮肾穿刺； 输尿管镜； 碎石术； 护理 　　Perioperative Nursing of the Patients with Complicated Nephrolithiasis Undergoing Percutaneous Nephrolithotomy by Ureteroscopy 　　　Abstract： Objective: To sum up the experience of nursing complicated nephrolithotomy with ureteroscopy perioperation，and explore the effective nursing. Method: Retrospective analysis of clinical data about 38 patients with complicated nephrolithiasis undergoing percutaneous nephrolithotomy by ureteroscopy. The nursing countermeasure is strengthening preoperatively psychological nursing and preoperative preparation, monitoring and nursing postoperative bleeding, keeping the drainage tube clear, preventing infection, giving good outpatients guidance. Result: 38 cases was successfully, 28 cases uderwent one stage procedure, 73.1% renal calculi were free after one stage procedure, another 6 cases underwent two stages, 15.7% renal calculi were free after two stages, 4 patients underwent ESWL for residual fragments after two stage procedure. The mean hospitalization time was 8.7 days.the average hospitalization time after surgery was 5.5 days. no major intraoperative and postoperative complications were found. Conclusion: Preoperative fully preparation and necessary psychological nursing lay the foundation for successful operation. Postoperative pertinent nursing measure is indispensable, Complications should be effectively prevented, Make the patients go through tthe period of perioperation safely. 　　Key words： Percutaneous nephrolithotomy； Urerteroscopy； Lithotrity 　　我院于2002年6月至2005年8月采用微创经皮肾输尿管镜取石术（MPCNL）治疗38例铸形结石和肾多发性结石病人，取得满意的效果，现将护理体会报道如下： 　　1 资料与方法 　　1.1 临床资料：本组38例，男24例，女14例，年龄31～60岁，平均42岁。左肾结