目的探讨经阴道自然腔道内镜手术(NOTES)辅助腹腔镜重复肾输尿管切除术的护理。方法回顾性分析2013年10月-2015年7月施行4例经阴道NOTES辅助腹腔镜重复肾输尿管切除术的临床资料。术前做好心理护理,完善检查,明确诊断,做好充分的皮肤、肠道及阴道准备为手术创造有利条件。术后严密观察生命体征,预防肾创面出血及尿性囊肿,预防压疮及深静脉血栓等卧床并发症。结果 4例手术均成功,术中、术后均未出现严重并发症,手术创伤小、恢复快、疗效确切、体表不留疤痕、美容效果佳且不影响术后性功能,手术效果满意。结论术前积极准备、术后严密观察病情,做好各引流管的护理,积极预防术后并发症的发生,能提高手术疗效,促进患者康复。 Objective To investigate the nursing of laparoscopic repeat nephroureterectomy (VATES) assisted by transvaginal natural endoscopic surgery (NOTES). Methods The clinical data of 4 cases of transvaginal NOTES assisted laparoscopic radical nephroureterectomy from October 2013 to July 2015 were retrospectively analyzed. Good preoperative psychological care, improve the examination, a clear diagnosis, adequate skin, gut and vaginal preparation for the operation to create favorable conditions. Postoperative close observation of vital signs, prevention of renal wound bleeding and urinary cysts, prevention of pressure ulcers and deep venous thrombosis and other bed complications. Results All the 4 operations were successful. There were no serious complications during and after operation. The operative trauma was small, the recovery was rapid, the curative effect was definite, the body surface did not leave scar, the cosmetic effect was good, the postoperative sexual function was not affected, and the operation effect was satisfactory. Conclusion Active preparation before surgery, strict observation of the disease after surgery, good diversion tube care, and actively prevent the occurrence of postoperative complications, can improve the surgical efficacy and promote patient rehabilitation.