1. Etiological treatment The most ideal treatment is to remove the etiology of hydronephrosis and keep the affected kidney. If the obstruction does not cause serious irreversible lesions, good results can be obtained after removing the cause. The surgical method depends on the nature of the cause. For example, congenital ureteropelvic junction stenosis can be treated by pyeloplasty, and renal and ureteral calculi can be treated by lithotripsy or lithotomy. These operations can be performed by endoscope in recent years. Hydronephrosis and renal function will be improved after operation.
2. If the nephrostomy is in critical condition or the cause of hydronephrosis cannot be removed, drainage should be performed above the obstruction first, and the operation of removing the cause should be performed after the infection is controlled. When the cause of obstruction cannot be relieved, nephrostomy should be used as a permanent treatment.
3. Nephrectomy When hydronephrosis is serious, the remaining renal parenchyma is too little, or accompanied by serious infection, that is, pyonephrosis, if the contralateral renal function is good, the diseased kidney can be removed.
(d) postoperative care of patients with hydronephrosis
1Pc urine leakage
Related factors: related to surgery.
Nursing measures: (1) use metronidazole 10ml as drainage tube for washing renal pelvis twice a day;
(2)TDP irradiated the wound for 30 minutes, once a day/kloc-0;
(3) Record the urine volume of left kidney and the volume of wound drainage tube;
(4) Inform the doctor to change the dressing in time after it is soaked.
(5) Keep the drainage unobstructed, and properly fix the drainage tube to prevent compression, folding and distortion.
2 infection
Related factors: related to surgical trauma and indwelling catheter
Nursing measures: (1) Use antibiotics according to the doctor's advice;
(2) measure the body temperature four times a day;
(3) Wash the urethral orifice twice a day with 0. 1% bromogeramine, and change the drainage bag every day;
(4) Keep the drainage unobstructed, and strictly carry out various aseptic operations;
(5) After anal exhaust, encourage patients to drink more water, more than 3000ml per day, and eat.
A nutritious diet.
3 pain
Related factors: related to surgical trauma.
Nursing measures: (1) Comfort patients to relax their nervousness;
(2) Instruct patients and their families to use the analgesic pump correctly, protect the painful parts and master the relief.
A painful method;
(3) Give analgesics according to the doctor's advice, and observe and record the effect after medication;
(4) Adjust the comfortable posture.
Risk of skin damage
Related factors: related to postoperative bed rest.
Nursing measures: (1) explain the importance of keeping skin intact to patients and their families, and obtain their cooperation, and
Explain to them the methods of skin self-care and the risk factors of skin injury;
(2) Assisting patients to change their postures regularly and orderly, and massaging each bony process;
(3) Clothes, trousers and mattresses should be kept soft, flat, dry, clean and free of residue;
(4) Instruct patients in bed activity skills and make bed activity plans.
5 constipation
Related factors: related to bed rest.
Nursing measures: (1) Encourage patients to strengthen bedridden activities;
(2) Eat more foods with high fiber content such as vegetables and fruits, and drink more water;
(3) Patients can be given physical defecation when defecation is difficult;
(4) Instruct patients to develop good defecation habits.
In addition, I suggest that patients should be treated with traditional Chinese medicine, such as uremia patients.