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目的分析探讨腹腔镜下根治性膀胱全切回肠代膀胱术的围手术期护理方法及效果。方法将2014年3月至2015年3月我院收治的38例膀胱癌患者纳入本次研究,均给予腹腔镜下根治性膀胱全切联合回肠代膀胱术进行治疗,并于围手术期采取护理干预处理措施,进一步评价围手术期护理效果。结果 38例患者均经手术治疗治愈出院,手术时间4.4~5.3 h,平均(4.8±0.2)h;住院时间18~36 d,平均(27±4)d;术后排气时间2~8 d,平均(5.9±1.1)d;置管时间14~27 d,平均(19.8±0.2)d;术后盆腔引流时间4~15 d,平均(11.8±0.4)d;引流量82~329 mL,平均(182.6±21.9)mL。手术后均没有感染、尿瘘以及吻合口瘘等并发症发生。出院后经6个月~1年随访,复查患者肾功能均恢复至正常水平,且无复发者。结论针对膀胱癌患者,采取腹腔镜下根治性膀胱全切联合回肠代膀胱术治疗有效,但在围手术期需注意护理干预措施的实施,以此降低手术并发症的发生,进而促进手术成功率的提高。
Objective To analyze and discuss the perioperative nursing methods and results of laparoscopic radical ileal neobladder. Methods 38 cases of bladder cancer admitted to our hospital from March 2014 to March 2015 were enrolled in this study. All patients underwent laparoscopic radical cystectomy combined with ileal neobladder for treatment and perioperative nursing Intervention measures to further evaluate the perioperative care effect. Results All 38 patients were cured by surgery. The operation time was 4.4-5.3 h (4.8 ± 0.2 h), the hospitalization time was 18-36 days (mean, 27 ± 4 days), and the duration of postoperative exhaust was 2-8 days , Averaged (5.9 ± 1.1) days; catheterization time was 14-27 days (mean, 19.8 ± 0.2 days); pelvic drainage time was 4-15 days (mean, 11.8 ± 0.4 days) Average (182.6 ± 21.9) mL. No infection after surgery, urinary fistula and anastomotic leakage occurred. After discharge from 6 months to 1 year follow-up, renal function were restored to normal levels, and no recurrence. Conclusion For patients with bladder cancer, radical laparoscopic radical cystectomy combined with ileal neobladder therapy is effective, but nursing interventions should be implemented during perioperative period to reduce the incidence of surgical complications and thus promote the success rate of surgery Improve.