Title Zdravstvena njega bolesnika s urostomom Title (english) HEALTH CARE OF UROSTOMA PATIENTS Author Anita Čagalj Mentor Marijan Šitum (mentor)Committee member Diana Aranza (predsjednik povjerenstva)Committee member Mario Podrug (član povjerenstva)Committee member Marijan Šitum (član povjerenstva)Granter University of Split Defense date and country 2019-09-16, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Rak mokraćnog mjehura zauzima šesto mjesto najučestalijih malignoma u 2018.g. Ova bolest zauzima 6. mjesto najučestalijih malignoma kod muškaraca, a 17. mjesto kod žena. Hrvatska je na 12. mjestu sa stopom od 13,7%. Prosječna dob u trenutku dijagnoze je 65 godina. Oko 75 % slučajeva biva otkriveno u stadiju lokaliziranom na mjehur, a ostalih 25 % uznapredovalom, proširenih na reigionalne limfne čvorove ili s razvijenim udaljenim metastazama. Bolesnici s rakom mokraćnog mjehura se najčešće prezentiraju simptomom prisutnosti krvi u mokraći koja može biti mikroskopska i makroskopska. Krvarenje može biti intermitentno ili kontinuirano. U manjem postotku hematuriju mogu pratiti znakovi iritabilnosti mjehura: frekvencija, urgencija i dizurija. Simptomi uznapredovalog stadija bolesti uključuju bol u kostima radi metastaza, bol lumbalno kod retroperitonealne diseminacije i hidronefroza u slučaju opstrukcije uretera.
Standardna klinička praksa i prva linija postupanja je TUR (transuretralna resekcija) mokraćnog mjehura. To je endoskopski zahvat koji ima dvojaku funkciju: uzimanje uzoraka za patohistološku analizu te potencijalno kurativan učinak za neinvazivne, lokalizirane tumore. Zlatni standard liječenja lokalnog i lokalno uznapredovalog mišićno invazivnog raka mokraćnog mjehura je radikalna cistektomija. Radikalna cistektomija zahtijeva rekonstrukciju donjeg urotrakta. Prva korištena derivacija urina je bila ureterosigmoidostoma gdje su se ureteri implantirali u sigmoidni kolon. U današnjoj kliničkoj praksi razlikujemo dvije vrste urinarne derivacije: inkontinentnu te kontinentnu. U inkontinentne metode urinarne derivacije spadaju derivacija vijugom ileuma (tzv. Brickerova vijuga) te ureterokutaneostomija.
Dobra edukacija bolesnika i obitelji može bitno utjecati na poboljšanje njegove kvalitete života, a kvalitetna zdravstvena njega utječe na brži oporavak i povratak bolesnika u svakodnevne životne aktivnosti. Stoga je bitna kako fizička, tako i psihička prijeoperacijska priprema, gdje je vodeća uloga medicinske sestre o edukaciji, kako bolesnika, tako i njegove obitelji.
Abstract (english) Bladder cancer has become a common cancer globally. It is the sixth most common malignancy in men and 17th in women%. The average age at diagnosis is 65 years. About 75% of cases are detected at the stage localized to the bladder and the other 25% advanced, extended to the renal lymph nodes or with advanced distant metastases. Patients with bladder cancer are most often presented with a symptom of the presence of blood in the urine, which can be microscopic and macroscopic. The bleeding may be intermittent or continuous. In a smaller percentage, hematuria may be accompanied by signs of bladder irritability: frequency, urgency and dysuria. Symptoms of advanced disease include bone pain for metastases, lumbar pain with retroperitoneal dissemination, and hydronephrosis in the case of ureteral obstruction.
Standard clinical practice and the first line of treatment is bladder TUR (transurethral resection). It is an endoscopic procedure that has a dual function: sampling for pathohistological analysis and potentially curative effect for non-invasive, localized tumors. The gold standard for the treatment of locally and locally advanced muscularly invasive bladder cancer is radical cystectomy. Radical cystectomy requires reconstruction of the inferior urotract. The first urine derivative used was the ureterosigmoidostoma, the ureter implanted into the sigmoid colon. In today's clinical practice, we distinguish between the two types of urinary derivation: continent and incontinent. Incontinent methods of urinary derivation include ileum (Bricker's) and ureterocutaneostoma.
Good education of the patient and family can have a significant impact on improving patients quality of life, and quality health care affects the faster recovery and return of the patient to daily life activities. Therefore, both physical and psychological preoperative preparation is essential, where the nurse's leadership role is to educate both the patient and his or her family
Keywords
rak mokraćnog mjehura
transuretralna resekcija
medicinska sestra (ključne riječi unio urednik)
Keywords (english)
bladder cancer
transurethral resection
nurse (ključne riječi unio urednik)
Language croatian URN:NBN urn:nbn:hr:176:109708 Study programme Title: Nursing (university/undergraduate) Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2020-06-25 15:37:06
