斜仰卧位联合截石位微创经皮肾钬激光碎石的手术护理
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摘要
目的总结斜仰卧位联合截石位在微创经皮肾镜下钬激光碎石中的手术护理经验。方法回顾性分析2014年1月至2016年12月南通市第一人民医院利用斜仰卧位联合截石位下行微创经皮肾镜钬激光碎石取石术治疗55例上尿路结石患者的临床资料及护理方法。结果 55例患者在术中安放体位前后以及术中血压心率以及脉搏均无明显改变,所有患者均顺利完成手术,术中、术后无严重并发症。结论手术室护士对斜仰卧位联合截石位微创经皮肾钬激光碎石的手术体位充分的理解和掌握以及良好的术前准备,熟练、合理、有效的手术配合,是保证手术及护理顺利进行、最大限度的预防手术并发症、达到最佳手术效果的重要措施。
Objective To summarize the experience of minimally invasive percutaneous transhepatic holmium laser lithotripsy with oblique supine and lithotomic position. Methods The clinical data and nursing methods of minimally invasive percutaneous nephrolithotomy lithotripsy in 55 patients with upper urinary calculi, who admitted to Nantong First People's Hospital during January 2014 to December 2016, were retrospectively analyzed by using oblique supine and lithotomic position. Results There were no significant changes intraoperative blood pressure, heart rate and pulse in 55 patients before and after postoperative placement for 55 patients who successfully completed the operation.No serious complications occurred during and after operation. Conclusion The operating room nurses' full understanding and mastery of operative position, good preoperative preparation and skilled, reasonable and effective operation cooperation are important measures to ensure the smooth operation and nursing, to prevent the complications of operation to the maximum extent and to achieve the best effect of operation.
Objective To summarize the experience of minimally invasive percutaneous transhepatic holmium laser lithotripsy with oblique supine and lithotomic position. Methods The clinical data and nursing methods of minimally invasive percutaneous nephrolithotomy lithotripsy in 55 patients with upper urinary calculi, who admitted to Nantong First People's Hospital during January 2014 to December 2016, were retrospectively analyzed by using oblique supine and lithotomic position. Results There were no significant changes intraoperative blood pressure, heart rate and pulse in 55 patients before and after postoperative placement for 55 patients who successfully completed the operation.No serious complications occurred during and after operation. Conclusion The operating room nurses' full understanding and mastery of operative position, good preoperative preparation and skilled, reasonable and effective operation cooperation are important measures to ensure the smooth operation and nursing, to prevent the complications of operation to the maximum extent and to achieve the best effect of operation.
引文
[1]杨建新,吴希庆,白刚,等.经皮肾镜双导管碎石清石术与钬激光碎石术治疗复杂性肾结石的疗效比较[J].中国临床新医学, 2014, 7(4):327-330.
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[8]彭丽,王兰英.斜仰卧位联合截石位经皮肾镜碎石取石术112例护理配合[J].齐鲁护理杂志, 2014, 20(2):78-79.
[9]张彩虹.斜仰卧位微创经皮肾碎石的护理配合[J].全科护理, 2012,10(7):1921-1922.
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[11]谢宗兵,周仁实,陈忠冼.斜仰卧-截石位和俯卧位经皮肾镜碎石术治疗巨大肾结石的疗效比较[J].岭南现代泌尿外科, 2013, 13(3):192-194.
[2]许连航,黎晓燕,经皮肾镜取石术体位的研究概况[J], 2016, 9(9):848-850.
[3] LEZREK M, AMMANI A, BAZINE K, et al. The split-leg modified lateral position for percutaneous renal surgery and optimal retrograde access to the upper urinary tract[J]. Urology, 2011, 78(1):217-220.
[4] XU KW, HUANG J, GUO ZH, et al. Percutaneous nephrolithotomy in semisupine position:a modified approach for renal calculuss[J].Urol Res, 2011, 39(6):467-475.
[5]王跃强,杨智明,黄曦,等.斜卧位超声引导微通道经皮肾镜碎石取石术137例报告[J].中华腔镜泌尿外科杂志, 2011, 5(3):245-246.
[6]保凌,陈君.安置手术体位的细节管理及护理进展[J].护理实践与研究, 2010, 7(19):101-103.
[7]余海涛.经皮肾镜气压弹道治疗肾结石的护理体会[J].中国实用医药, 2011, 6:18.
[8]彭丽,王兰英.斜仰卧位联合截石位经皮肾镜碎石取石术112例护理配合[J].齐鲁护理杂志, 2014, 20(2):78-79.
[9]张彩虹.斜仰卧位微创经皮肾碎石的护理配合[J].全科护理, 2012,10(7):1921-1922.
[10]梅骅,陈凌武,高新.泌尿外科手术学[M]. 3版.北京:人民卫生出版社, 2008:793-799.
[11]谢宗兵,周仁实,陈忠冼.斜仰卧-截石位和俯卧位经皮肾镜碎石术治疗巨大肾结石的疗效比较[J].岭南现代泌尿外科, 2013, 13(3):192-194.