北京生物醫(yī)學(xué)工程

輸尿管軟鏡鈥激光碎石術(shù)在上尿路結(jié)石合并心衰患者中的應(yīng)用及其細(xì)節(jié)護(hù)理

Application of ureteroscopic holmium laser lithotripsy and its detail care for patients with upper urinary stone combined with heart failure

作者：隗春燕羅勇李虹姜永光

單位：首都醫(yī)科大學(xué)附屬北京安貞醫(yī)院（北京100029） <p>通信作者：姜永光，教授，博士生導(dǎo)師。E-mail：[email protected]</p> <p> </p>

關(guān)鍵詞：輸尿管軟鏡鈥激光碎石術(shù)；應(yīng)用；上尿路結(jié)石；心衰；細(xì)節(jié)護(hù)理

分類號：R318.6 

出版年·卷·期（頁碼）：2022·41·3（302-306）

摘要：

目的分析輸尿管軟鏡鈥激光碎石術(shù)及其細(xì)節(jié)護(hù)理在上尿路結(jié)石合并心衰患者的臨床應(yīng)用效果，為該術(shù)式的臨床推廣提供實驗依據(jù)。方法選取2019年1月至2021年1月北京安貞醫(yī)院泌尿外科行輸尿管軟鏡激光碎石術(shù)的上尿路結(jié)石合并心衰患者共82例，并按照圍手術(shù)期采用細(xì)節(jié)護(hù)理（實驗組）和常規(guī)護(hù)理（對照組）分成兩組，每組41例。分析患者的不良反應(yīng)發(fā)生率、手術(shù)治療滿意度、患者手術(shù)前后的焦慮自評量表(self-rating anxiety scale，SAS)和抑郁自評量表(self-rating depression scale ，SDS)評分，以及疼痛評分和生活能力Barthel量表評分，與此同時比較兩種護(hù)理模式的差異。結(jié)果行輸尿管軟鏡鈥激光碎石術(shù)82例手術(shù)患者中發(fā)生不良反應(yīng)共13例，占比15.9%，其中實驗組不良反應(yīng)發(fā)生率低于對照組(P<0.05)。對手術(shù)滿意有75例，為91.5%，實驗組手術(shù)滿意度高于對照組(P<0.05)。手術(shù)后，患者的疼痛和日常生活能力評分都好于術(shù)前，且實驗組疼痛評分低于對照組(P<0.05)，日常生活能力評分高于對照組(P<0.05)。患者術(shù)后的SAS量表和SDS量表評分低于術(shù)前(P<0.05)，且實驗組SAS量表和SDS量表評分低于對照組(P<0.05)。結(jié)論針對上尿路結(jié)石合并心衰患者，輸尿管軟鏡鈥激光碎石術(shù)具有較好的臨床應(yīng)用前景，且細(xì)節(jié)護(hù)理可有效提高臨床療效。

Objective To analyzing the clinical effects of the soft ureteroscope holmium laser lithotripsy and targeted detail nursing in upper urinary stone patients combined with heart failure, and to provide a practice for its clinical promotion. Methods From January 2019 to January 2021, 82 patients with upper urinary tract stones complicated with heart failure, who underwent ureteroscopic holmium laser lithotripsy in Beijing Anzhen hospital, were divided into experimental group and control group, 41 cases each. The experimental group adopted target detail care during the perioperative period, and the control group received routine nursing. The incidence of adverse reactions, satisfaction with the surgical treatment, and the self-rating anxiety scale (SAS) , self-rating depression scale (SDS) scores, pain score and life ability Barthel scale score before and after soft ureteroscope holmium laser lithotripsy were analyzed. Meanwhile, the difference between the two groups was compared. Results A total of 13 patients with adverse reactions occurred in 82 patients, accounting for 15.9%, however the incidence of adverse reactions in the experimental group was lower than the control group ( P <0.05) . Seventy-five patients were satisfied with the operation, accounting for 91.5%, and the satisfaction of the experimental group was higher than that of the control group (P<0.05). After operation, the patient's pain and daily living ability were better than preoperative, and the experimental group pain score was lower than the control group ( P<0.05), daily life ability score was higher than the control group (P<0.05). After the operation, both of the scores of the patients’ SAS and SDS scales were lower than before the operation (P<0.05), and the SAS amount table and SDS scale scores of the experimental group were lower than those of the control group (P<0.05).. Conclusions For patients with upper urinary calculi combined with heart failure, the soft ureteroscopic holmium laser lithotripsy has good clinical application prospects, and targeted detail care can effectively improve its clinical effect.

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