达芬奇机器人辅助腹腔镜行肾部分切除术患者的护理

目的探讨达芬奇机器人辅助腹腔镜行肾部分切除术(robot-assisted laparoscopic partial nephrectomy,RALPN)患者的护理措施。方法回顾性分析2011年5月至2013年2月瑞金医院泌尿外科治疗的12例RALPN患者的临床资料,所有患者术前重点进行术前评估、心理护理、肠道准备等,术后进行心理护理、严密的生命体征监测、切口护理、引流管护理、导尿管护理、呼吸道护理、活动训练、饮食护理,采取积极预防措施预防并发症的发生。结果患者手术时间为(177.6±26.4)min,肾动脉阻断时间为(30.7±8.6)min、失血量为(281.8±217.1)ml、肛门排气恢复时间为(1.7±0.6)d、引流管留置时间为(9.0±1.9)d、导尿管留置时间为(9.4±1.2)d、术后下床活动时间为(6.3±1.3)d、住院时间为(12.5±1.9)d。术后病理检查示肾透明细胞癌8例、肾平滑肌脂肪瘤3例、多房囊性肾癌1例。结论 RALPN具有创伤小、患者术后恢复快等优势,能明显降低护理难度和提高护理质量和效率,值得临床推广。

Nursing of Robot-assisted Laparoscopic Partial Nephrectomy

Objective To summarize the nursing strategy of patients undergoing robot-assisted laparoscopic partial nephrectomy（RALPN）.Methods The clinical data of 12 patients undergoing RALPN were analyzed retrospectively.RALPN group patients had postoperative assessment,psychological nursing,bowel preparation before the surgery,and had psychological nursing,strict monitoring of vital signs,operative incision and drain tube nursing,urethral catheter nursing,respiratory care,early functional exercise,diet nursing after surgery to prevent the postoperative complications.Results The surgery time was（177.6±26.4）min,renal artery block time was（30.7±8.6）min,blood loss（281.8±217.1）ml,passage of gas by anus recovery time（1.7±0.6）d,drainage tube indwelling time（9.0±1.9）d,urethral catheter indwelling time（9.4±1.2）d,off bed activity time was（6.3±1.3）d,postoperative hospitalization time was（12.5±1.9）d.Postoperative pathological examination showed that 8cases of patients had renal clear cell carcinoma,3cases of renal angiomyolipoma,1case of multilocular cystic renal cell carcinoma.Conclusion RALPN have obvious advantages with fewer traumas,faster postoperative recovery.It can significantly reduce the difficulty and workload of nursing care and improve the quality and efficiency of nursing care,which is worthwhile for clinical trial.