中华护理杂志2024,Vol.59Issue(8) :930-933.DOI:10.3761/j.issn.0254-1769.2024.08.005

1例机器人辅助切除巨大肾细胞癌伴Ⅲ级癌栓患者的护理

Perioperative nursing of a patient with massive renal cell carcinoma and Mayo stageⅢ tumor thrombus undergoing robot-assisted nephrectomy

毛云涛 陈丽莉 陈笑笑 王莺
中华护理杂志2024,Vol.59Issue(8) :930-933.DOI:10.3761/j.issn.0254-1769.2024.08.005

1例机器人辅助切除巨大肾细胞癌伴Ⅲ级癌栓患者的护理

Perioperative nursing of a patient with massive renal cell carcinoma and Mayo stageⅢ tumor thrombus undergoing robot-assisted nephrectomy

毛云涛 1陈丽莉 2陈笑笑 1王莺1
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作者信息

  • 1. 310003 杭州市 浙江大学医学院附属第一医院手术室
  • 2. 温州医科大学附属第一医院护理部
  • 折叠

摘要

总结1例机器人辅助下切除巨大肾细胞癌伴MayoⅢ级癌栓患者术中大出血合并CO2气体栓塞的围手术期护理经验,护理要点如下.术前参与多学科讨论,制订阶梯式术中应急预案;建立一体化护理工作站,优化病情监测.术中加强机器人辅助手术的护理配合;密切监测患者病情,预防术中危重并发症;启动应急预案,积极处理大出血合并CO2气体栓塞;实施结构化体位管理,预防术中坠床风险.术后预防继发性血栓形成及活动性出血;加强肝肾缺血-再灌注损伤的监测与护理.经过多学科救治及精心护理,患者于术后13 d顺利出院.

Abstract

This research provides an overview of the perioperative nursing care for a patient with a massive renal cell carcinoma and Mayo Stage Ⅲ tumor thrombus who underwent a robot-assisted nephrectomy complicated by sig-nificant intraoperative bleeding and CO2 embolism.Key nursing considerations included multidisciplinary preoperative discussions,developing stepwise intraoperative emergency plans,establishing an integrated nursing workstation,and the optimization of patient monitoring.During the surgery,nursing efforts were focused on supporting the robot-as-sisted procedure,closely monitoring the patient's condition,preventing intraoperative complications,initiating emergency plans as needed,actively managing major bleeding and CO2 embolism,and implementing structured positioning to minimize the risk of falls during the procedure.Postoperatively,the focus was on preventing secondary thrombus formation,managing active bleeding,and monitoring for liver and kidney ischemia-reperfusion injury.Through multi-disciplinary interventions and meticulous nursing care,the patient was discharged after a 13-day postoperative recovery.

关键词

机器人手术/肾细胞癌/下腔静脉癌栓/围手术期护理

Key words

Robotic Surgery/Renal Cell Carcinoma/Inferior Vena Cava Tumor Thrombus/Perioperative Nursing

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出版年

2024
中华护理杂志
中华护理学会

中华护理杂志

CSTPCD北大核心
影响因子:5.365
ISSN:0254-1769
参考文献量9
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