双J管护理的.ppt

泌尿外科患者留置双J管并发症的观察及护理 张 凌 暨南大学第二临床学院泌尿外科 教学目标 了解双J管内引流可能出现的并发症 掌握相应的护理方法及出院宣教 留置双J管的适应范围 输尿管整形术 肾盂及输尿管切开取石术 膀胱癌根治术及输尿管狭窄扩张术 输尿管镜下碎石术 留置双J管的意义 引流尿液、解除梗阻、保护肾功能 减少术后漏尿 防止尿路狭窄 创伤小、术后恢复快 手术方式 截石位 连续硬膜外麻醉 国产或进口F8双J管 手术或膀胱镜置入 手术方式 手术或膀胱镜置入 一端卷曲于肾盂内 一端卷曲于膀胱内 置管时间4——6周 并发症的观察及处理 尿路刺激征 原因 位置不当或移位导致 处理 调整体位观察症状变化、解痉、膀胱镜调整 并发症的观察及处理 血尿 原因 活动量过大使导致双J管滑脱、上下移动 处理 卧床、多饮水、抗炎止血、观察尿液变化 并发症的观察及处理 感染 原因 血块堵塞，失去引流作用 处理 多饮水，保持导尿管通畅，每日更换尿袋；会阴部护理，抗炎治疗 并发症的观察及处理 腰痛 原因 输尿管尿液反流（使用双J管后，膀胱输尿管抗返流机制消失，膀胱压大于肾盂压引起尿液返流 ） 处理 减少腹压，保持大便通畅，勿憋尿 出院宣教 定期复诊，一月后拔管 置管期间注意休息 高糖、高蛋白、易消化饮食 多饮水，结石患者禁食高钙食物 不能体力劳动 提问 留置DJ管的主要目的？ * * Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profil