经皮肾镜碎石术的围手术期护理新模式探索

目的探讨经皮肾镜碎石术（PCNL）的围手术期护理模式。方法对2012年1月一2013年12月866例行经皮肾镜碎石术患者，术前予以健康宣教、心理护理及体位训练，术后实施医护一体化伤口护理及管道管理，积极处置感染性休克、肋间神经痛、漏尿和皮下气肿，同时给予饮食及健康指导。结果866例患者顺利完成手术，术后感染发生率2．4％，感染性休克发生率O．2％，出血2．2％，漏尿1．5％，气胸O．6％，皮下气肿0．3％，肋间神经痛0．6％。全体患者经对症治疗及精心护理均康复出院，平均住院时间为（11．2±2．8）d。结论创新的护理模式与护理技巧对PCNL手术的成功具有重要意义。

Exploration of New Perioperative Nursing Mode for Percutaneous Nephrolithotomy

Objective To explore the perioperative nursing mode for percutaneous nephrolithotomy （PCNL）. Methods A total of 866 patients with PCNL having undergone lithotripsy between January 2012 and December 2013 in our hospital were included in our study. Before surgery, they received position training, health education and psychological nursing. After surgery, patients received an integral medical wound care and pipeline management, as well as management of infectious shock and intercostal neuralgia. At the same time, we gave them dietary guidance and other health guidance. Results All the patients were successfully discharged from hospital. Postoperative infection rate was 2.4%, septic shock rate was 0.2%, bleeding rate was 2.2%, urinary leakage rate was 1.5%, the rate of pneumothorax was 0.6%, subcutaneous emphysema rate was 0.3%, and intercostal neuralgia rate was 0.6%. The average hospital stay was （11.2± 2.8） days. Conclusion The innovative nursing mode and techniques have great significance on the success of PCNL surgery.