经腹和腹腔镜下子宫肌瘤剔除术的护理体会(1)
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[摘要] 目的：探讨经腹和腹腔镜下子宫肌瘤剔除术后的护理经验。方法：回顾性分析39例经腹子宫肌瘤剔除术患者和57例腹腔镜下肌瘤剔除术患者的临床及护理资料，在护理过程中采用术前心理辅导、对症处理及出院指导等护理措施。结果：全部病例手术顺利，术后患者恢复良好，未出现并发症，均痊愈出院。腹腔镜下肌瘤剔除术组术后发热、术后使用止痛剂及住院时间情况均低于经腹子宫肌瘤剔组，差异有统计学意义(P<0.05)。结论：根据患者的不同术式，采取有针对性的护理措施，可有效避免手术并发症，促进患者如期康复。腹腔镜下肌瘤剔除术患者具有恢复快的优势。
[关键词] 子宫肌瘤；腹腔镜；护理
[中图分类号] R473.6[文献标识码]C [文章编号]1673-7210(2009)01(c)-078-03
The experience in nursing patients after transabdominal myomectomy or laparoscopic myomectomy
CAO Dong-fu1, CHEN Xiao-yan1,2
(1.Zixing City of Chinese Medicine Hospital, Zixing423400, China; 2.Department of Gynecology, Second Xiangya Hospital, Central South University, Changsha410011, China)
[Abstract] Objective: To investigate the nursing experience of transabdominal myomectomy or laparoscopic myomectomy. Methods: Clinical and nursing data of 39 patients involved with transabdominal myomectomy and 57 patients involved with laparoscopic myomectomy were analyzed retrospectively. In the course of nursing, we gave them psychological counselling, guidance symptomatic treatment and discharged from hospital care, and other measures. Results: All patients were operated successfully, recovered well, were cured without complications, and discharged. The indications of fever, using analgesic and length of stay after laparoscopic myomectomy were less than that after transabdominal myomectomy. There was significant difference (P<0.05). Conclusion: Based on the different surgical type and taking care of targeted measures, the complications can be effectively avoided. Laparoscopic myomectomy can remove myoma of uterus in patients with the advantages of quick recovery.
[Key words] Myoma of uterus; Laparoscopic; Nursing
子宫肌瘤(myoma of uterus)是女性生殖器最常见的一种良性肿瘤，好发年龄为30～50岁;主要症状以阴道不规则出血，经量增多，经期延长，腹部包块，压迫症状为多见。妇科手术是治疗子宫肌瘤的重要手段，近20年来，随着腹腔镜手术的广泛开展，腹腔镜下子宫肌瘤剔除术(laparoscopic myomectomy，LM)正逐步成为子宫肌瘤剔除术的治疗方法之一[1]。现将我院2006年1月～2008年6月妇产科实施经腹子宫肌瘤剔除术和腹腔镜下子宫肌瘤剔除术的围术期护理经验总结如下：
1资料与方法
1.1一般资料
2006年1月～2008年6月我科收治的经腹子宫肌瘤剔除术患者39例，年龄29～52岁，平均(10.83±8.05)岁，浆膜下肌瘤25例(64.10%)，肌壁间肌瘤14例(35.90%)，肌瘤最大径线长为3.6～9.0 cm，平均(5.9±2.1) cm；腹腔镜下子宫肌瘤剔除术患者共57例，年龄26～47岁，平均(38.92±5.16)岁，浆膜下肌瘤39例(68.42%)，肌壁间肌瘤18例(31.58%)，肌瘤最大径线长为3.3～8.5 cm，平均(5.7±1.9) cm。患者入院后经常规妇科检查及B超检查，完善各项常规术前检查，无手术禁忌证，排除子宫内膜病变及其他性质的病变。术后均经病理学检查证实为子宫肌瘤。两组患者年龄、术前肌瘤类型及大小无显著性差异(P>0.05)，具有可比性。
1.2治疗
96例患者手术过程顺利，无术中并发症发生。术后常规随访3个月，均恢复良好。
1.3统计学方法
数据以均数±标准差(x±s)表示，两组术后发热、使用止痛剂、肛门排气时间、住院天数和恢复工作时间的情况比较采用χ2检验和两样本t检验 ......
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