护理论著CHINESE COMMUNITY DOCTORS 中国社区医师2020年第36卷第20期快速康复外科概念是指术中及术后应用各种已证实有效的方法以减少手术应激及并发症，加速患者术后康复[1]。前列腺增生症是引起中老年男性排尿障碍最为常见的一种非肿瘤性病变[2]，发病率随年龄递增。随着治疗下尿路症状的有效药α肾上腺素受体阻滞剂和5α还原酶抑制剂在前列腺增生症患者中使用，需行手术治疗的时间往往被推迟，而且患者多为高龄，同时合并有多种器官疾病，耐受性差，手术风险高[3]。有研究表明，在留置尿管时间、住院时间、出血量等方面，铥激光行前列腺剜除术优于经尿道前列腺电切术[4]。本文主要探讨快速康复联合预见性护理在经尿道前列腺铥激光剜除术患者围术期中的实施效果，现报告如下。资料与方法2017年1月-2019年1月收治经尿道前列腺铥激光剜除术的高龄高危患者82例，随机分为两组。对照组41例，年龄78～99岁，平均(84±2.46)岁；肾积水6例，肾功能不全8例，尿潴留留置尿管10例，慢性阻塞性肺部疾病4例，高血压20例。观察组41例，年龄78～96岁，平均(85±1.21)岁；肾积水5例，肾功能不全5例，尿潴留留置尿管13例，慢性阻塞性肺部疾病2例，高血压23例。两组一般资料比较，差异无统计学意义(P ＞0.05)，具有可比性。本研究经伦理委员会批准。纳入标准：①符合疾病诊断标准；②年龄≥78岁；③无手术禁忌证；④无前列腺手术史；⑤清醒；⑥患者及家属均签署知情同意书。
排除标准：①合并其他前列腺疾病；②神经源性膀胱；③糖尿病；④术前存在并发症；⑤脑部疾病、精神疾病。方法：两组均采用腰麻或腰硬联合麻醉下行经尿道前列腺铥激光剜除术。⑴对照组给予常规护
理措施：术前准备，对症治疗基础疾病，并做好并发症护理。⑵观察组给予常规护理措施的同时，实施快速康复理念联合预见性护理：①术前健康宣教和心理护理：患者高龄，听力下降，反应迟钝，沟通困难。因此，我们除了常规宣教以外，责doi:10.3969/j.issn.1007-614x.2020.20.084
基金项目2017年度广西医药卫生自筹经费计划课题(编号：Z20170155)
摘要目的：观察快速康复理念联合预见性护理在前列腺增生患者围手术期中的效果。方法：2017年1月-2019年
1月收治经尿道前列腺铥激光剜除术的高龄高危患者82例，随机分为两组，各41例。观察组给予快速康复理念联合
预见性护理；对照组给予常规护理。比较两组护理效果。结果：观察组膀胱痉挛发生率显著低于对照组，患者满意度
显著高于对照组，术后膀胱冲洗、留置尿管、平均住院时间显著短于对照组，差异有统计学意义(P ＜0.05)。结论：快
速康复理念联合预见性护理在经尿道前列腺铥激光剜除术高龄患者围手术期中应用，能够降低术后膀胱痉挛发生率，
警句格言
加速患者康复，提高患者满意度。
财务管理目标
弘觉寺关键词快速康复外科；前列腺增生；并发症
Obrvation on the effect of rapid rehabilitation concept combined with predictive nursing on patients with prostatic
hyperplasia during perioperative period
Li Chengli,Liu Juzhen
Urology Surgery,Guangxi Jiangbin Hospital,Guangxi Nanning 530021
党政机关公文付东流Fund Project Guangxi Medical and Health Self Financing Project in 2017(NO.:Z20170155)
Abstract Objective:To explore the effect of rapid rehabilitation concept combined with predictive nursing on patients with
prostatic hyperplasia during perioperative period.Methods:From January 2017to January 2019,82elderly high-risk patients who
电脑怎么切换窗口underwent transurethral thulium lar enucleation of prostate were lected and randomly divided into two groups of 41cas in
each.The obrvation group was given the rapid rehabilitation concept combined with predictive nursing.The control group was
given routine care.We compared the effect of the two groups.Results:In the obrvation group,the incidence of bladder spasm was
significantly lower than that in the control group,the satisfaction of patients was significantly higher than that in the control group,
and the postoperative bladder flushing,indwelling catheter,and average hospital stay were significantly shorter than that in the
control group,the difference was statistically significant(P ＜0.05).Conclusion:The application of rapid rehabilitation concept
combined with predictive nursing on elderly high-risk patients who underwent transurethral thulium lar enucleation of prostate
during perioperative period can reduce the incidence of postoperative bladder spasm,accelerate the recovery of patients,and
improve the satisfaction of patients.
Key words Rapid rehabilitation surgery;Prostatic hyperplasia;Complications丝绸之路旅游
快速康复理念联合预见性护理
对前列腺增生患者围手术期的效果观察
李程莉刘菊珍
530021广西江滨医院泌尿外科，广西南宁
稻草人故事
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