腹腔镜下根治性膀胱切除联合乙状结肠原位新膀胱术患儿34例的护理

发布时间：2018-04-30 15:52

本文选题：小儿 + 根治性全膀胱切除　；参考：《实用医学杂志》2017年06期

【摘要】：目的:总结34例膀胱横纹肌肉瘤患儿行腹腔镜根治性全膀胱切除+乙状结肠原位膀胱术的护理措施及效果。方法:术前给予多学科协作制定治疗方案、做好家属心理护理、化疗药物副作用的观察和处理;术后给予循序渐进的营养支持、管道护理、个性化的伤口护理以及控尿、排尿功能训练指导。结果:34例患儿取得了良好的治疗效果,未发生出血、尿瘘、吻合口瘘等并发症;随访10个月有2例患儿达到完全尿控,其余患儿均日间尿控良好,有6例患儿夜间睡眠时较差,随着年龄的增加和手术后时间延长,尿控率逐渐提高。结论:膀胱横纹肌肉瘤患儿行腹腔镜根治性全膀胱切除+乙状结肠原位膀胱术,采用多学科协作,术前讨论确定化疗方案、手术方式,针对性对患儿家属实施心理指导;术后循序渐进的营养支持、个性化的伤口护理、尿控管理以及出院健康指导有助于手术获得成功,有效的减少了术后并发症的发生,使患者达到了满意的治疗效果。
[Abstract]:Objective: To summarize the nursing measures and effects of 34 children with rhabdomyosarcoma of the bladder with laparoscopic radical cystectomy and sigmoid in situ cystectomy. Methods: a multidisciplinary cooperation scheme was given before the operation, the psychological nursing of the family, the observation and treatment of the side effects of chemotherapeutic drugs were done, and the nutritional support was given gradually after the operation. Nursing, personalized wound care and urinary function training guidance. Results: 34 cases had good treatment effect, no bleeding, urinary fistula, anastomotic fistula and other complications; 2 cases had complete urine control for 10 months, the rest of the children had good daytime urinary control, 6 cases were poor at night sleep and increased with age. Conclusion: the patients with rhabdomyosarcoma of the bladder are treated with laparoscopic radical cystectomy and sigmoid in situ cystectomy. Multidisciplinary cooperation is used to determine the chemotherapy regimen before operation. The surgical method is directed to the family members of the children's family Shi Xinli; progressive nutritional support and personality after operation. The wound care, urine control management and discharge health guidance are helpful to the success of the operation, which effectively reduces the postoperative complications and makes the patients achieve a satisfactory therapeutic effect.

【作者单位】：南方医科大学珠江医院泌尿外科;
【分类号】：R473.73

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