摘要
目的采用随机对照研究,探讨早期综合护理干预在预防正位回肠膀胱术后患者尿潴留中的应用价值。方法连续纳入2014年10月至2016年10月因膀胱癌于我科行根治性膀胱全切正位回肠膀胱术的患者60例,按随机数字表法分为实验组和对照组,各30例。对照组接受常规护理,实验组在常规护理的基础上实施早期综合护理干预(包括心理干预、行为干预和认知干预等),分别在术后3、6、12个月随访时统计患者排尿日记记录情况及尿潴留相关预防措施(包括定时排尿、蹲式排尿、Valsalva呼吸式排尿、提肛运动)的完成情况,记录患者B超下残余尿量和尿潴留的发生率,对结果进行统计分析。结果实验组患者术后3、6、12个月总体随访项目完成率均高于对照组(87.3%、83.0%、72.8%vs 55.5%、51.2%、44.2%;P<0.01);实验组患者术后12个月排尿日记完成率,术后3个月和6个月定时排尿、Valsalva呼吸式排尿完成率,以及整个随访期间蹲式排尿和提肛运动的完成率均明显高于对照组(P<0.05);实验组患者术后3次随访时B超下测得残余尿量及尿潴留的发生率较对照组明显降低(P<0.05)。结论早期综合护理干预可提高正位回肠膀胱术后患者院外依从性,降低残余尿量及尿潴留的发生率。
Objective To assess the value of early comprehensive nursing care in preventing urinary retention in patients with orthotopic ileal neobladder. Methods This randomized controlled trial was conducted among 60 patients with bladder cancer undergoing radical cystectomy and orthotopie ileal neobladder reconstruction in our department between October, 2014 and October, 2016. The patients were randomized into control group （n = 30） and experimental group （n = 30） to receive routine nursing and early comprehensive nursing interventions （including psychological, behavioral and cognitive interventions） on the basis of routine nursing, respectively. At 3, 6 and 12 months after the operation, all the patients were assessed for completion of urinary diary and fulfilment of the preventive measures against urinary retention （ including regular urination, squatting urination, Valsalva respiratory urination, and contraction of the levator ani muscles）, and the residual urine volume and incidence of retention were compared between the two groups. Results At 3, 6 and 12 months after the operation, the overall completion rates of the preventive measures were 87.3% , 83.0% , and 72.8% in the experimental group, respectively, significantly higher than the rates in the control group （55.5% , 51.2% , and 44.2% , respectively; P 〈0.01 ）. The completion rates of urinary diary at 12 months, regular urination and Valsalva respiratory urination at 3 and 6 months, and squatting urination and levator ani movement during the entire follow-up period were significantly higher in the experimental group than in the control group （ P 〈 0.05 ）. The residual urine volume and incidence of urinary retention were significantly lower in the experimental group than in the control group in all the 3 follow-up examinations （P 〈 0. 05 ）. Conclusion Early comprehensive nursing care can improve the patient compliance and reduce the residual urine and incidence of urinary retention in patients with orthotopic ileal neobladder
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2018年第4期362-366,共5页
Journal of Third Military Medical University
关键词
膀胱肿瘤
膀胱切除术
尿潴留
护理干预
urinary bladder neoplasms
cystectomy
urinary retention
nursing intervention
