保留肾单位肾部分切除术患者的围手术期护理

1/1保留肾单位肾部分切除术患者的围手术期护理保留肾单位肾部分切除术患者的围手术期护理【摘要】目的：

探讨保留肾单位的肾部分切除术的术前、术后护理方法，总结护理经验，以提高护理质量。

方法：

选取泌尿外科12例肾癌（直径?4cm）患者施行保留肾单位的肾部分切除术，并进行有效的术前术后护理，观察术后早期恢复情况、并发症及舒适程度。

结果：

12例患者均手术成功，无明显并发症，恢复情况良好。

结论：

精湛的手术技巧，充分的术前准备和精心的围手术期护理及病情观察是保证手术顺利进行、提高手术成功率、减少和预防手术并发症的发生、促进患者康复的重要措施。

【关键词】肾癌；保留肾单位；肾部分切除术；围手术期；护理肾癌（renalcarcinoma）亦称肾细胞癌，是起源于肾实质泌尿小管上皮系统的恶性肿瘤，为最常见的肾实质恶性肿瘤，约占成人恶性肿瘤的2%--3%。

外科手术治疗的主要方法有根治性肾切除术和保留肾单位的肾部分切除术（NSS）。

保留肾单位手术主要适用于早期的偶发肾癌，且肿瘤直径?4cm的患者，先天性孤立肾、对侧肾功能不全或无功能者以及双侧肾癌等。

保留肾单位手术后局部复发率0―10%，而肿瘤4cm手术后局部复发率0―3%。

（1）有研究显示肾部分切除术与根治性肾切除术比较，其5年生存率分别为85%和93%，无显著性差异。

由于肾组织脆嫩，血运丰富，不易愈合，肾部分切除术后易发生出血，因此术后的观察与护理非常重要。

我院自2011年9月―2013年5月共行开放性保留肾单位的肾部分切除术12例，术后恢复良好，现将护理体会总结如下：

1.1临床资料本组病例12例，其中男9例，女3例，年龄在29-76岁之间，平均年龄52岁，均无明显临床症状，平时体健，于体检时发现，均为单侧肾癌，对侧肾脏健康，肿瘤直径均小于4CM，术后一例发生脂肪液化，其余均顺利恢复。

1.2手术方法本组手术均采用气管插管全麻，健侧卧位，升高腰桥，妥善固定肢体，行保留肾单位肾部分切除术。

增加内容2.护理2.1术前护理2.1.1心理护理了解病人的心理需要，根据病人不同的心理特点，以明确的语言，诚恳的态度向病人详细介绍手术的意义、必要性和注意事项。

并介绍既往成功病例，讲解手术方法和步骤，使患者对手术及术后效果有正确的认识。

鼓励家属共同参与到患者的护理中，使患者以良好的精神状态迎接手术。

对晚上睡眠不佳的患者，可适当给予镇静药物。

2.2.2了解全身状况协助患者做好术前各项检查，了解患者心、肝、肾等器官情况，监测体温、血压、血糖等，使其维持在正常范围内。

作肾图检查，了解患侧及对侧肾功能。

2.2.3常规术前准备：

常规备皮、备血，指导患者练习床上进食和大小便，向患者及家属讲解术后绝对卧床的重要性。

术前戒烟2周以上，术前禁食12小时，禁饮6-8小时，术前晚灌肠，术晨留置胃管，以减轻术后腹胀。

2.2术后护理2.2.1术后去枕平卧6小时，头偏向一侧，防止舌后缀及分泌物误吸引起吸入性肺炎。

尤其术后使用麻醉镇痛泵的患者，因药物副作用，部分患者会出现恶心、呕吐症状，注意保持患者呼吸道的通畅，必要时可遵医嘱给予止吐药物。

2.2.2术后严密观察生命体征的变化术后常规给持续低流量吸氧2升/分，心电监测24―48小时，严密观察心率、血压、指脉氧等情况。

2.2.3术后取平卧位休息，由于肾组织脆嫩，血运丰富，不易愈合，因此肾部分切除的患者需绝对卧床休息2周以上，告知?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颊呒凹沂舨皇实钡幕疃?蚬?缦麓不疃?岬贾律霾卸似屏殉鲅?＃?）因此翻身时需保持患者腰背部呈直线，防止因翻身、剧烈咳嗽等动作而发生出血。

卧床期间进行关节及肢体的按摩和被动活动，促进血液循环，减少下肢血栓形成。

两周后可先在床上做踏车之类轻微的活动，促进肌肉张力恢复。

待病情允许后，可在家属参与下进行床旁活动。

2.2.4引流管的护理2.2.4.1留置尿管的护理保持尿道口及会阴部的清洁，每日用0.5%的碘伏棉球消毒2次，保持尿管引流通畅，避免引流袋高于耻骨联合，同时注意观察尿液的颜色及尿量。

2.2.4.2腹膜后引流管的护理保持引流通畅，避免引流管打折弯曲或脱出，每日更换引流袋并准确记录引流液的性质、颜色及量，引流袋低于创口水平，防止逆行感染。

如引流量100ml/h且颜色鲜红，时间持续2小时以上，应立即通知医生处理。

2.2.5术后并发症的观察及护理2.2.5.1出血出血多发生于术后3-5天，术后出血主要由于肾创面止血不彻底引起。

应密切观察心率、血压、呼吸、尿液等生命体征的变化。

注意伤口敷料有无渗血，腰腹部有无肿胀、饱满甚至淤血情况。

（3）注意