This paper summarizes the perioperative nursing of 237 patients with renal or proximal ureteral calculi treated by upper-pole access in minimally invasive percutaneous nephrolithotomy. The related complications included pleural injury in 28 cases(11.8 percent),excessive bleeding in 2 cases(0.8 percent) .postoperative fever( ≥38℃) in 22 cases(9.3 percent),postoperative pain in 52 cases(21.9 percent),urinary extravasation in 5 cases(2.1 percent). All patients recovered well after intensive treatment and nursing. In order to promote patient recovery,nurses should make a comprehensive preoperative assessment, provide psychological care and postural training before surgery,provide careful intraoperative coordination and observation, closely observe the changes of vital signs and hemoglobin,provide careful nursing of drainage tube,closely observe the characters and amount of draining liquids,pay attention to the changes of the chest and abdomen,detect and treat postoperative complications timely,and provide proper discharge guidance.%总结237例应用肾上盏入路经皮肾镜取石术治疗肾或输尿管上段结石的围手术期护理.相关的并发症包括胸膜损伤28例(11.8％),严重出血2例(0.8％),术后发热(≥38℃)22例(9.3％),术后疼痛52例(21.9％),尿外渗5例(2.1％).所有患者经过精心的治疗和护理均恢复良好.认为术前做好综合评估、心理护理和体位训练,术后严密观察生命体征和血红蛋白的变化,做好引流管的护理,细心观察引流液的性状与数量,注意胸腹部的症状与体征,及时发现和处理并发症,给予细致的出院指导,有利于患者早日康复.
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