单纯体外冲击波碎石术治疗鹿角形肾结石患者的护理

报道189例鹿角形肾结石患者单纯行体外冲击波碎石术治疗的护理要点。术前做好心理护理和胃肠道准备，术中密切注意观察患者呼吸、脉搏、心率、面色、肢体动作、体位等变化，特别警惕室性心律不齐的发生。术后做好体位排石护理，早期尽量减少活动，以免碎石从肾脏排出太多太快阻塞输尿管，可采取患侧卧位（即治疗侧在下）；对于已经形成输尿管石街的患者，嘱患者多做跳跃运动，多饮水，以利结石排出；对于结石碎屑堆积在肾下盏的患者可行胸膝卧位或倒立位排石法；加强对血尿、疼痛、发热等并发症的观察和护理。本组所有结石均被完全粉碎，3个月结石排净率为78．8％，并发症发生率较低，有1例出现寒战、高热、剧烈腰痛等症状，为碎石屑堆积于输尿管所致，经综合排石治疗和护理，石街自行排出，未出现严重并发症。

Experience in Caring the Patients with Buckhorn-shaped Calculi Treated with Singular Extracorporeal Shock Wave Lithotripsy

The paper reported the key points of caring 189 patients with buckhorn-shaped calculi treated with singular extracorporeal shock wave lithotripsy. Before operation, mental care and intestinal preparation were performed. During operation, the respiration, pulse, heart rate, complexion, movement of extremities and lying position were closely observed, especially the occurrence of ventricle arrhythmia, After operation, care of extracorporeal lithotripsy was performed, movement was reduced to avoid the calculi blocking uri- nary tract at early stage, and sideward lying position was suggested. For those with calculi stuffing the urinary tract, the patients were encouraged to do jogging exercise, drink more water for the benefit of exiling calculi. Those with calculi converging at hypo-calyces were encouraged to take knee lying position and upside-down position. Meanwhile, a close observation over urination with hemorrhage, pains and fever was conducted. In this study, all the calduli were crushed by lithotripsy. Expulsion rate reached 78.8% three months after lithotripsy, with lower complications. Only one had shivering, fever and severe lumbago, which resulted from the calculi converging at urinary tract. After further treatment and care, the calculi were expelled from the tract automatically, no severe complications coming out.