论文评阅结果:
论文题目:
论文评阅人:
广东医学院成人高等教育本科毕业论文
几种常见引流管在泌尿外科患者手术后的护理及
应用
姓 名:黄玉芳
年级专业班:2014级护理本科
学 号:1452701040097
论文提交时间:2016年06月
- 1 -
- 2 - -
目 录
摘 要 ······························································································1 关键词 ·····························································································1 1 研究背景及意义 ··············································································2 2引流管的分类 ·················································································2 3引流管的应用 ·················································································3 4引流管的一般护理 ···········································································4 5不同引流管的特殊护理 ·········································································5 6 结论 ··························································································· 7 参考文献 ························································································ 7
- 1 -
【摘要】引流管经常被各种泌尿外科手术后的患者使用,在泌尿外科手术患者中应用颇为广泛。它可影响患者手术成败和术后康复,而护理是其重要的方面。本文通过探讨泌尿外科引流管的护理及应用,根据患者的情况,选择适宜的引流管加强护理,对放置引流管的患者进行观察,护理,减少患者的痛苦,有效改善病情的同时,提高手术成功率,帮助患者早日康复。 【关键词】泌尿外科 引流管 护理 应用
- 1 -
1 研究背景及意义
泌尿外科术后病人的引流管多,因此导致护理工作较为复杂。引流管起着引流尿液,保持尿流通畅,压迫止血或引流切口外渗出的积液,促进切口愈合,观察术后有无出血、漏尿及防止尿路狭窄的作用。它的这些特点决定了护理引流管的重要性:一旦引流管滑出,有可能引起出血、尿漏、尿道狭窄等病发症而使手术失败。各引流管与泌尿系统的康复有着密切的关系。 2引流管的分类
要做好泌尿外科引流管护理,首先必须了解引流管的种类。熟悉本科各种引流管的作用。常用的引流管有:膀胱造瘘管;留置导尿管(普通导尿管、三腔导尿管);双J管;输尿管;支架管;T字流管等多种引流管。
2.1 膀胱造瘘管:留置位置一般在耻骨上,常用蕈状导尿管以充分引流尿液,适用于有尿潴留但尿管不能从尿道口插入者或是经膀胱手术后暂时性或永久性留置管道者,如尿道断裂的患者等。
2.2 留置导尿管:是指经尿道插入膀胱引流尿液的尿管。主要用于各种手术后留置导尿、尿潴留时引流尿液、测膀胱残余尿及膀胱尿道造影等。常用的留置导尿管有以下三种:① 带气囊的二腔导尿管,标准结构包括排液腔对开排液孔(一对)、排液漏斗、注水腔、注水孔(一个)、注水漏斗、单向阀、气囊。② 三腔导尿管:常用于经尿道前列腺电切和经尿道膀胱肿瘤电切术后,其标准结构包括注水腔、注药腔、排液腔、注水漏斗、单向阀、注药漏斗、排液漏斗、侧错开排液孔、侧开注药孔、气囊、注水孔、止流卡片,主要增加了侧开注药孔或称冲水孔,以便于持续膀胱冲洗,防止血凝块堵塞管道。③ 硅胶管带气囊的二腔前列腺导尿管:常用于前列腺增生并发尿潴留且不宜手术、 需终身带管以解除尿潴留者,其末端弯而细尖,且较硬挺,容易通过狭窄部进入膀胱,给予留置导尿。
2.3 肾周引流管:为肾盂手术时放置在肾周围的引流管,引流术中残留在肾周围的积血积液,一般在术后5-7 d拔除。
2.4 输尿管支架管:临床常用双J 管,一端通过输尿管置于肾盂内,一端在膀胱内,起到内支架作用。用于肾盂内引流,输尿管切开取石、输尿管成型、输尿管再植或同种异体肾移植等手术时放置的管道。能有效地预防切口尿瘘和切口感染,缩短住院时间,
-
- 2 -