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Exploration of New Perioperative Nursing Mode for Percutaneous Nephrolithotomy

ObjectiveTo explore the perioperative nursing mode for percutaneous nephrolithotomy (PCNL). MethodsA total of 866 patients with PCNL having undergone lithotripsy between January 2012 and December 2013 in our hospital were included in our study. Before surgery, they received position training, health education and psychological nursing. After surgery, patients received an integral medical wound care and pipeline management, as well as management of infectious shock and intercostal neuralgia. At the same time, we gave them dietary guidance and other health guidance. ResultsAll the patients were successfully discharged from hospital. Postoperative infection rate was 2.4%, septic shock rate was 0.2%, bleeding rate was 2.2%, urinary leakage rate was 1.5%, the rate of pneumothorax was 0.6%, subcutaneous emphysema rate was 0.3%, and intercostal neuralgia rate was 0.6%. The average hospital stay was (11.2±2.8) days. ConclusionThe innovative nursing mode and techniques have great significance on the success of PCNL surgery.

The Nursing Experience of Preoperative Treatment for Urethral Injury with Ureteroscopic Urethral Realignment

ObjectiveTo explore the nursing experience of preoperative treatment for urethral injury with ureteroscopic urethral realignment. MethodsThe key points of the nursing experience of preoperative treatment for 58 cases of urethral injury with ureteroscopic urethral realignment were retrospectively analyzed. The patients were treated between January 2008 and December 2012. ResultsUrethra catheterization of the 58 patients receiving the ureteroscopic urethral realignment was all successful. The catheter was extracted 4-8 weeks after the treatment, and then the urethra was dilated for two years. All patients had normal urination without any surgery complications during the 5-28-month clinical follow-up. ConclusionUrinary tract infections can be prevented effectively under professional and meticulous preoperative treatment. The incidence of urethral stricture can be reduced greatly. The quality of the patients' life can be improved a lot.

喉癌合并2型糖尿病患者的围手术期护理

【摘要】　目的　总结喉癌合并2型糖尿病患者的围手术期护理经验。　方法　2005年7月-2010年6月，对62例喉癌合并2型糖尿病患者围手术期护理的临床资料进行归纳总结。　结果　25例行喉全切除术、20例行垂直半喉切除术、17例行水平半喉切除术。经过精心护理和专科处理，患者均顺利度过围手术期康复出院。　结论　对喉癌合并2型糖尿病患者，其术前术后的饮食指导和血糖控制及感染预防，是患者获得手术成功和疾病治愈的关键。

内镜黏膜下剥离术治疗胃肠道间质瘤的围手术期护理

目的　总结内镜黏膜下剥离术（ESD）治疗胃肠道间质瘤的围手术期护理方法。 方法　回顾分析2007年1月－2011年8月符合内镜下治疗77例胃肠道间质瘤患者行ESD的临床资料和护理措施。 结果　77例患者全部经内镜完整切除肿瘤，其中3例出现出血，5例发生穿孔，2例发生术后狭窄，经内科保守治疗、内镜下治疗以及围手术期精心护理，患者痊愈出院。 结论　ESD治疗胃肠道间质瘤安全、有效，正确细致的各项护理措施是胃间质瘤患者手术获得成功、且身体早日康复的有力保障。

食管异物伴穿孔感染后胃镜下取出并置入空肠营养管的围手术期护理一例

The Perioperative Nursing Means of the Acute Obstructive Suppurative Cholangipis with Diabetes

目的:探讨糖尿病合并化脓性胆管炎(acute obstructive suppurative cholangipis,AOSC)患者围手术期护理方法。方法:回顾性分析我院2002 年1月至2008 年8 月收治的15 例糖尿病合并化脓性胆管炎患者的临床资料。结果:本组2例术后伤口裂开,1例切口裂开胆道大出血死亡,3 例发生肺部感染,无低血糖休克病例,9例伤口愈合良好,按期拆线。结论:加强围手术期的观察和护理,对糖尿病合并化脓性梗阻性胆管炎患者的治疗起着重要作用。

Development and application of a multidisciplinary nursing program for Prader-Willi syndrome with spinal deformity in perioperative period

Objective To develop a multidisciplinary nursing program for Prader-Willi syndrome with spinal deformity and evaluate its effectiveness in clinical practice. Methods In July 2016, a multidisciplinary collaborative team was established before the treatment of children with Prader-Willi syndrome complicated with spinal deformity. For the nursing difficulties in the perioperative period, relevant literature was consulted, and a multidisciplinary collaborative nursing plan was formulated, which included nutrition management and blood glucose control, management of obstructive sleep apnea hypopnea syndrome, behavioral intervention related to mental change, and early identification and management of complications. The developed multidisciplinary collaborative nursing program was applied to three children with Prader-Willi syndrome complicated with spinal deformity in Peking Union Medical College Hospital from July 2016 to October 2018, and their postoperative recovery was evaluated. Results One child had inguinal skin ulceration when admitted to hospital, which was significantly improved after active treatment. The perioperative blood glucose level control of the three children was satisfactory, and there was no postoperative gastrointestinal dysfunction, deep wound infection, respiratory complications, internal fixation failure or other complications, and no asphyxia, fall, loss, or other adverse events. The follow-up compliance after discharge was 100%. Conclusions Multidisciplinary collaboration programs can escort patient’ safety and promote their recovery, improve the professional level of nursing staff, and reflect the nursing value. As a working mode, it can be further popularized and used for reference in the nursing of other difficult diseases.

风湿性心脏病合并慢性粒细胞白血病围手术期护理一例

经眼上静脉栓塞治疗外伤性颈动脉海绵窦瘘的围手术期护理

目的探讨经眼上静脉路径，栓塞治疗外伤性颈动脉海绵窦瘘 (TCCF) 的围手术期的护理。 方法对 1998年 10月－2010年 9月收治的 13例眼上静脉动脉化 TCCF 患者行微弹簧圈栓塞治疗，并对术前、术中、术后规范护理措施及方法进行总结。 结果12例术后造影瘘口消失且颈内动脉通畅，颅内杂音消失，经过围手术期的精心护理，突眼、眼外肌运动受限和球结膜肿胀 1 周内基本消失。1 例填入 5枚弹簧圈后，微导管脱离瘘口，术中造影瘘口仍显示，1 周后球囊阻断实验阴性后闭塞颈内动脉主干，患者临床症状消失。术后 3～12 个月对10例患者进行脑血管造影复查，仅1例复发。 结论对于球囊闭塞困难的外伤性颈动脉海绵窦瘘，且眼上静脉动脉化患者，采用微弹簧圈栓塞治疗安全、有效。做好围手术期的护理，对提高治疗效果、预防并发症有重要意义。

婴幼儿腹腔镜下先天性食管裂孔疝修补术围手术期护理

目的　总结婴幼儿腹腔镜下食管裂孔疝修补术围手术期的护理方法与经验，以提高护理质量。 方法　对2011年6月－2012年10月收治的8例先天性食管裂孔疝患儿行腹腔镜下食管裂孔疝修补术的护理方法及要点进行回顾性分析。 结果　患儿均顺利完成手术，1例术后第2天开始发热，并持续高热伴咳嗽，经补液、抗感染、雾化吸入等治疗，1周后体温恢复正常，伤口愈合良好，但仍有咳嗽，经儿内科会诊以支气管肺炎转入儿内科治疗。其他患儿无并发症发生，痊愈出院。经随访，8例患儿无腹痛腹胀，无疝复发，无食管狭窄等发生。 结论　术前加强饮食指导、体位护理、皮肤护理，术后做好呼吸道管理、胃管护理、积极抗感染治疗，预防肺部并发症等有效护理措施是婴幼儿腹腔镜下先天性食管裂孔疝修补手术成功的关键。