膀胱全切回肠新膀胱术围手术期的护理体会

目的：探讨膀胱全切除回肠新膀胱术围手术期的护理要点。方法对该院泌尿外科2009年3月—2011年12月共23例因膀胱癌行膀胱全切回肠新膀胱术患者的临床及护理资料进行了收集和分析。结果 23例患者均手术成功,其中5例术后因支架管及尿管堵塞发生短暂性尿漏,给予管道冲洗并保持通畅后,均明显改善。1例患者术后第7天,发生小肠不完全性梗阻,给予持续胃肠减压、禁食后,3 d后解大便,腹痛腹胀症状消失。2例女性患者出现尿失禁,给予盆底肌训练、新膀胱排尿训练后好转。大多数患者出院后均可经尿道正位控制排尿。结论加强膀胱全切回肠新膀胱术围手术期的护理是患者的恢复的重要保证。

Perioperative nursing experience with patients in radical cystectomy and reconstruction of bladder with ileum

Objective To investigate the key points of nursing in radical cystectomy and reconstruction of bladder with ileum.Methods We collected and analyzed the data of 23 cases with bladder cancer treated by radical cystectomy and reconstruction of bladder with ileum from March 2009 to December 2011 in the Department of Urinary Surgery of our hospital.Results 23 cases were operated successfully,including 5 cases with leakage of urine temporal due to the stuck of stand tube and ureter,which were improved significantly after giving pipelines flushing and keeping pipelines open.One case had incomplete intestinal obstruction 7 days after operation,giving gastrointestinal decompression and abstinence,they defecated and abdominal pain disappeared 3 days later.2 female patients were in urinary incontinence,after giving pelvic floor muscle and new bladder training,it became better.All patients could control urination by the right way.Conclusions To enhance perioperative nursing is the important guarantee for the recovery of patients who under go radical cystectomy and reconstruction of bladder with ileum.