内镜下治疗消化道息肉护理干预探讨.docVIP

内镜下治疗消化道息肉护理干预探讨 　　[摘要] 目的:探讨内镜下治疗消化道息肉的护理干预方法,为提高手术成功率提供参考。方法:对我院58例消化道息肉患者进行内镜下电凝电切治疗护理干预,包括心理支持、肠道准备和术中配合以及加强术后并发症的预防。结果:58例患者均在内镜下顺利切除息肉,无1例肠穿孔发生、无并发症发生,出院前能演示造口护理技能,使其得到及时治疗。结论:合理的护理干预可以减轻或消除患者对手术的恐惧、提高手术成功率和减低术后并发症的发生率,是提高患者生存质量的重要保证。 　　[关键词] 内镜治疗;消化道息肉;护理 　　[Abstract] Objective:To investigate a nursing method to improve the succesive operation rate of hypoendo scope high frequency electrocision on colonicpolyp and surv ival qua lity of the patients. Methods:High frequency electroc isions were performed in 58 patients of colonic polyp and the psycho logical support,suffic ient bowel prepa ration and preoperative stomalocation were also made,the prevention of po stopera tive com plications w as streng thened,stoma nursing know ledge and skill were dem onstrated,family members were gu ided in regular recheck. Results: The colonic polyp w as resected success fully in all the patients, no one intestinal perfo ration or complications occurred,and all family mem bers could demonstratestom a nursing skill. Conclusion:It is vital to relieveor eliminate patients’ fear, pain and infer iority of patients,improve reoperative nutritiona lstate,have sufficient bowel preparation and preope ra tive stom a location,prevent postoperative complications and demonstrate stoma nursing know ledge and sk ill for raising succesive operation rate and survival quality. 　　[Key words] high frequency electric coagulation electrocision;colonic polyp; nursing 　　 　　内镜下高频电凝电切除手术治疗消化道息肉适用范围广,因其经济、简便、安全、痛苦少,而成为临床上治疗消化道良性息肉的首选方法。我科自2005年1月-2010年12月采用高频电凝电切除治疗此类病58例,均获得良好治疗效果,现报道如下。 　　1、临床资料 　　58例消化道息肉患者中,男38例,女20例;年龄24-86岁,平均43.6岁。其中食道息肉8例（8枚）,胃息肉14例（29枚）,十二指肠息肉12例（21枚）,结肠息肉24例（47枚）。根据形态、大小、部位选择不同术式,微波治疗广蒂小息肉疗效好,带蒂息肉则用尼龙圈套扎好,对广基较大息肉用射频多点烧灼好[2]。本组中射频治疗18例,尼龙套扎12例,微波治疗11例,高频电凝电切17例。58例中,对15例直径1.2cm的单发息肉和20例多发息肉患者均行内镜下活检,病检为腺瘤样息肉17例、增生性息肉24例和炎性息肉17例,无1例恶性肿瘤。 　　1.2方法 　　按内镜操作常规,进镜达病灶部位,将射频治疗仪的弥散电极板与患者右下肢紧密接触,在内镜直视下将治疗电极准确抵达隆起处,启动射频电子发生器,射频能量通过电极传送至组织,局部产生高热,使病变组织变白、起泡、固缩。射频输出功率控制在26-40W内,时间