网状支架植入术治疗前列腺电切术后排尿障碍患者的护理

目的介绍网状支架植入术治疗前列腺电切(transurethral resection of the prostate,TURP)术后排尿障碍患者的护理方法。方法回顾性分析2004-2011年在解放军第81医院治疗的36例良性前列腺增生患者的临床资料。所有患者均为行经尿道前列腺等离子电切术后并发排尿障碍患者,且均在局部麻醉下经超声引导置入镍钛记忆合金支架。结果 36例患者中有35例患者手术成功,支架置入5d后拔除导尿管,其中33例患者可自主排尿,尿流率恢复正常或接近正常,有效率为91.6%。1例患者因尿道狭窄未能植入支架而行膀胱造瘘,2例患者因不能耐受并发生血尿于术后第2天取出支架。结论网状支架治疗前列腺电切术后并发排尿障碍患者的效果确切,术前宣教、术中很好配合、术后进行针对性的护理,可提高术后患者的疗效。

Nursing of Metallic Mesh Stent Implantation in Treating Postoperative Voiding Dysfunction after Transurethral Resection of Prostate

Objective To introduce the clinical nursing methods of metallic mesh stent implantation in treating postoperative voiding dysfunction after transurethral resection of prostate （TURP）. Methods From 2004 to 2011,the clinical data of 36 patients with benign prostatic hyperplasia in the hospital were analyzed retrospectively. Nickel-titanium alloy stents were inserted under ultrasound-guidance and local anesthesia for patients with postoperative voiding dysfunction after TURP. Results In~the 36 patients, sur- geries were succeeded in 35 and the stents were removed 5 d after surgery. After surgery,33 patients were able to void spontaneously with few post-void residual volume of urine and the flow rates were normal or near normal. The total effective rate was 91.6%. Only one patient failed to implant the stents and conduc- ted line cystostomy due to urethral stricture,and two patients removed the stents 2 d after stent implanta- tion due to severe urinary tract symptoms and hematuria. Conclusion Metallic mesh alloy stent implanta- tion for the treatment of voiding dysfunction after TURP has a sound therapeutic effect. Perioperative pro- motion,well organized intraoperative cooperation and targeted postoperative nursing contribute to better therapeutic effect.