快速康复外科理念在HoLEP术围手术期护理中的应用

目的：探讨快速康复外科理念在经尿道前列腺钬激光剜除术(HoLEP)患者围手术期护理中的应用效果。方法回顾性分析该院2014—2015年期间收治的89例因良性前列腺增生症(BPH)而导致膀胱出口梗阻(BOO)的患者,术式均为经尿道前列腺钬激光剜除术,在围手术期运用先进的快速康复外科理念,采取术前充分准备、心理疏导、术中保温、灌洗通畅、保证术后睡眠,留置止痛泵,术后早期进食,早期拔除尿管,防治患者术后并发症,做好术后健康指导和出院指导等,术后注意观察患者拔管时间、住院天数、症状改善情况及并发症发生率等情况。结果89例接受钬激光前列腺剜除术的患者均恢复良好,1例术后继发性出血,5例出现术后尿路感染,10例出现短暂性急迫性尿失禁,经保守治疗后,均顺利出院。结论采用快速康复外科理念指导HoLEP术围手术期的治疗,可减少手术并发症,促进患者的术后康复。

Application of Fast Track Surgery in Perioperative Nursing of HoLEP Op-eration

Objective To study the application effect of fast track surgery in perioperative nursing of patients with transurethral holmium laser enucleation of the prostate. Methods 89 cases of patients with bladder outlet obstruction (BOO) caused by benign prostatic hyperplasia (BPH) admitted and treated in our hospital from 2014 to 2015 were retrospectively analyzed and were treated with transurethral holmium laser enucleation of the prostate, the advanced fast track surgery was applied in the perioperative period, the measures including adequately preoperative preparation, psychological counseling, intraoperative warming, unobstructed lavage, ensuring postoperative sleep, indwelling analgesic pump, early postoperative feeding and early catheter removal, prevention and treatment of postoperative complications and do a good job in postopera-tive health guidance and discharge guidance were taken, and the extubation time, length of stay, improvement of symptoms and incidence rate of complications were observed after operation. Results The recovery of 89 cases of patients with holmi-um laser enucleation of prostate was good, recurrent hyphema occurred to 1 case after operation, urinary tract infection oc-curred to 5 cases after operation, transient and urge urinary incontinence occurred to 10 cases, and all patients were dis-charged after conservative treatment. Conclusion The fast track surgery in guiding perioperative treatment of HoLEP opera-tion can reduce the operative complications and promote postoperative recovery of patients.