陈满桂

[摘要]目的 探讨手术室细节护理干预对控制腔镜肾切除术肾肿瘤患者术后感染的效果。方法 选取我院2015年6月～2016年8月收治的74例行腔镜肾切除术肾肿瘤患者作为研究对象，按照随机数字表法将为对照组和观察组，每组各47例。对照组采取常规护理，观察组在对照组的基础上使用手术室细节护理干预。观察两组术后恢复情况（术后下床活动时间及引流管留置、住院及进食、术后肛门排气时间等指标）及术后并发症（尿漏、尿性囊肿及下位肾功能缺失等）、感染的发生情况。结果 观察组术后肛门排气及引流管留置时间、进食、下床活动和住院时间均短于对照组，差异均有统计学意义（P<0.05）；观察组术后并发症发生率（5.40%）低于对照组（21.62%），观察组术后感染率（8.11%）低于对照组（27.03%），差异均有统计学意义（P<0.05）。结论 手术室细节护理干预可有效地降低術后感染发生率，降低其并发症发生率，促进患者恢复。

[关键词]手术室细节护理；腔镜肾切除术；肾肿瘤；术后感染；效果分析

[中图分类号] R472.3 [文献标识码] A [文章编号] 1674-4721（2018）9（c）-0186-03

Effect of detailed nursing intervention in operation room on controlling postoperative infection after endoscopic nephrectomy for patients with renal tumors

CHEN Man-gui

Operation Room， People′s Hospital of Linchuan District in Fuzhou City， Jiangxi Province， Fuzhou 344000， China

[Abstract] Objective To explore the effect of detailed nursing intervention in operation room on controlling postoperative infection after endoscopic nephrectomy. Methods A total of 74 patients with renal tumors undergoing endoscopic nephrectomy from June 2015 to August 2016 were selected as the research subjects. According to random number table method， they were divided into the control group and the observation group， 47 cases in each group. The patients in the control group were treated with routine nursing， and the patients in the observation group were treated with detail nursing intervention in on the basis of the control group. The postoperative recovery was observed and analyzed in the two groups （the time of ambulation， drainage tube indwelling， hospitalization and feeding， anus exhaust time after operation） and postoperative complications （urinary leakage， urinary cyst and lower renal function loss， etc.）， and the incidence of infection. Results The patients in the observation group were shorter than the control group （P<0.05）， and the incidence of postoperative complications （5.40%） in the observation group was lower than that of the control group（21.62%）， and the postoperative infection rate （8.11%） in the observation group was lower than that of the control group （27.03%）， the differences were statistically significant （P<0.05）. Conclusion The detailed nursing intervention in the operation room can effectively reduce the incidence of postoperative infection， reduce the incidence of complications and promote the recovery of patients with nephrectomy with endoscopic nephrectomy.

[Key words] Detailed nursing in operation room； Endoscopic nephrectomy； Renal tumor； Postoperative infection； Effect analysis

随着科学技术的发展，肾肿瘤的发生率越来越高，临床上已广泛应用腔镜肾切除术治疗，且临床效果明显，创口小，恢复快，但患者术后易出现交叉感染，而出现血液感染或切口感染，造成严重炎症反应，影响术后疗效[1-2]。有学者研究认为[3]，手术室是治疗疾病的重要场所，患者往往因室内环境及细节护理未完善而导致术后切口感染率上升，因此需系统的提高护理措施，限制探观人数，避免交叉感染，将感染的可能性降至最低，指出完善手术室细节护理干预可减少患者的切口感染率，应用综合性、细节化的护理降低患者的感染，使患者保持稳定的心态安全经历手术[4-5]。……