CAJ | 학술논문

目的：探讨达芬奇机器人辅助腹腔镜行肾部分切除术(robot-assisted laparoscopic partial nephrectomy,RALPN)患者的护理措施。方法回顾性分析2011年5月至2013年2月瑞金医院泌尿外科治疗的12例RALPN患者的临床资料,所有患者术前重点进行术前评估、心理护理、肠道准备等,术后进行心理护理、严密的生命体征监测、切口护理、引流管护理、导尿管护理、呼吸道护理、活动训练、饮食护理,采取积极预防措施预防并发症的发生。结果患者手术时间为(177．6±26．4)min,肾动脉阻断时间为(30．7±8．6)min、失血量为(281．8±217．1)ml、肛门排气恢复时间为(1．7±0．6)d、引流管留置时间为(9．0±1.9)d、导尿管留置时间为(9．4±1．2)d、术后下床活动时间为(6．3±1．3)d、住院时间为(12．5±1．9)d。术后病理检查示肾透明细胞癌8例、肾平滑肌脂肪瘤3例、多房囊性肾癌1例。结论 RALPN 具有创伤小、患者术后恢复快等优势,能明显降低护理难度和提高护理质量和效率,值得临床推广。
목적：탐토체분기궤기인보조복강경행신부분절제술(robot-assisted laparoscopic partial nephrectomy,RALPN)환자적호리조시。방법회고성분석2011년5월지2013년2월서금의원비뇨외과치료적12례RALPN환자적림상자료,소유환자술전중점진행술전평고、심리호리、장도준비등,술후진행심리호리、엄밀적생명체정감측、절구호리、인류관호리、도뇨관호리、호흡도호리、활동훈련、음식호리,채취적겁예방조시예방병발증적발생。결과환자수술시간위(177．6±26．4)min,신동맥조단시간위(30．7±8．6)min、실혈량위(281．8±217．1)ml、항문배기회복시간위(1．7±0．6)d、인류관류치시간위(9．0±1.9)d、도뇨관류치시간위(9．4±1．2)d、술후하상활동시간위(6．3±1．3)d、주원시간위(12．5±1．9)d。술후병리검사시신투명세포암8례、신평활기지방류3례、다방낭성신암1례。결론 RALPN 구유창상소、환자술후회복쾌등우세,능명현강저호리난도화제고호리질량화효솔,치득림상추엄。
Objective To summarize the nursing strategy of patients undergoing robot-assisted laparoscopic partial nephrectomy(RALPN).Methods The clinical data of 1 2 patients undergoing RALPN were analyzed retrospective-ly.RALPN group patients had postoperative assessment,psychological nursing,bowel preparation before the sur-gery,and had psychological nursing,strict monitoring of vital signs,operative incision and drain tube nursing, urethral catheter nursing,respiratory care,early functional exercise,diet nursing after surgery to prevent the post-operative complications.Results The surgery time was (177.6±26.4)min,renal artery block time was(30.7±8.6) min,blood loss(281.8±217.1)ml,passage of gas by anus recovery time(1.7±0.6 )d,drainage tube indwelling time (9.0±1.9)d,urethral catheter indwelling time(9.4±1.2)d,off bed activity time was(6.3±1.3)d,postoperative hos-pitalization time was(12.5±1.9)d.Postoperative pathological examination showed that 8 cases of patients had renal clear cell carcinoma,3 cases of renal angiomyolipoma,1 case of multilocular cystic renal cell carcinoma.Conclusion RALPN have obvious advantages with fewer traumas,faster postoperative recovery.It can significantly reduce the difficulty and workload of nursing care and improve the quality and efficiency of nursing care,which is worthwhile for clinical trial.