本文選題：小兒 + 根治性全膀胱切除��； 參考：《實用醫(yī)學(xué)雜志》2017年06期

【摘要】：目的:總結(jié)34例膀胱橫紋肌肉瘤患兒行腹腔鏡根治性全膀胱切除+乙狀結(jié)腸原位膀胱術(shù)的護理措施及效果。方法:術(shù)前給予多學(xué)科協(xié)作制定治療方案、做好家屬心理護理、化療藥物副作用的觀察和處理;術(shù)后給予循序漸進的營養(yǎng)支持、管道護理、個性化的傷口護理以及控尿、排尿功能訓(xùn)練指導(dǎo)。結(jié)果:34例患兒取得了良好的治療效果,未發(fā)生出血、尿瘺、吻合口瘺等并發(fā)癥;隨訪10個月有2例患兒達到完全尿控,其余患兒均日間尿控良好,有6例患兒夜間睡眠時較差,隨著年齡的增加和手術(shù)后時間延長,尿控率逐漸提高。結(jié)論:膀胱橫紋肌肉瘤患兒行腹腔鏡根治性全膀胱切除+乙狀結(jié)腸原位膀胱術(shù),采用多學(xué)科協(xié)作,術(shù)前討論確定化療方案、手術(shù)方式,針對性對患兒家屬實施心理指導(dǎo);術(shù)后循序漸進的營養(yǎng)支持、個性化的傷口護理、尿控管理以及出院健康指導(dǎo)有助于手術(shù)獲得成功,有效的減少了術(shù)后并發(fā)癥的發(fā)生,使患者達到了滿意的治療效果。
[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.

【作者單位】： 南方醫(yī)科大學(xué)珠江醫(yī)院泌尿外科;
【分類號】：R473.73

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