系统性膀胱功能锻炼对预防盆底重建术后尿潴留的效果研究

发布时间：2018-04-14 12:04

本文选题：膀胱功能训练 + 盆底重建术　；参考：《郑州大学》2017年硕士论文

【摘要】：目的:比较常规护理及系统性膀胱功能锻炼下两组患者尿管重置率、尿潴留发生率及拔管后残余尿量测定情况,探讨系统性膀胱功能煅练对预防盆底重建术后尿潴留的效果。通过实施护理干预,减低术后尿潴留的发生率,降低尿管重置率,预防泌尿系统感染,从而减轻患者的病痛。方法:本研究为类试验性研究,采取两种不同干预措施预防盆底重建术后尿潴留。2016年5月至2016年12月期间,根据整群随机原则将某医院两个妇科病区的符合入选标准的患者分配入试验组或对照组,两组患者各55例,对照组行常规护理,试验组在行常规护理的基础上实施系统性膀胱功能锻炼,干预时间从术前3天直至拔除尿管顺利排尿,责任护士收集记录两组患者干预后尿管重置率、尿潴留发生率、尿管留置时间、测残余尿量情况、尿常规结果、体温、膀胱刺激症状的发生率及尿路感染例数等指标。所有资料均采用SPSS 21.0统计软件处理。两组各观测指标中计量资料采用t检验进行比较,计数资料比较采用χ2检验及fisher’s确切概率法,检验水准α=0.05。结果:1.试验组共有12例患者重置尿管,尿管重置率为21.82%,对照组有23例患者,重置率41.82%。经检验,χ2=7.880,P0.05,两组患者尿管重置率差异有统计学意义。2.试验组共有13例患者被确认存在尿潴留,发生率为23.64%,对照组发生率为38.18%。经检验,χ2=6.714,P0.05,两组患者尿潴留发生率差异有统计学意义。3.试验组尿管留置时间为(55.14+19.53),对照组为(64.58+21.60),t=2.334,P0.05,差异有统计学意义;经检测,尿残余量为(20.45+27.00),对照组为(30.55+25.44),t=2.017,P0.05,差异有统计学意义,提示该方法可有效的减少尿液的潴留。4.对照组膀胱刺激征发生例数(19例)高于试验组(13例),其中对照组患者反映存在膀胱刺激征者占34.55%,试验组报告有膀胱刺激征的患者为23.64%。但是分析发现两组之间差异无统计学意义。5.试验组尿路感染发生率(5.45%)低于对照组(17.02%),主要判断方法为尿沉渣镜检结果中白细胞的数量,但两组之间差异无统计学意义。结论:系统性膀胱功能训练对预防盆底重建术后尿潴留的发生具有较好效果,尽管在预防尿路感染和减少膀胱刺激征方面效果不明显,但是在减少尿管重置率、缩短尿管留置时间、提高患者生活质量方面具有重要意义。
[Abstract]:Objective: to compare the urinary catheter replacement rate, urinary retention rate and residual urine volume after extubation in two groups under routine nursing and systemic bladder function exercise, and to explore the effect of systemic bladder function exercise on preventing urinary retention after pelvic floor reconstruction.Through nursing intervention, the incidence of urinary retention was reduced, the replacement rate of urinary catheter was reduced, urinary tract infection was prevented, and the pain of patients was alleviated.Methods: this study was a pilot study in which two different interventions were taken to prevent urinary retention after pelvic floor reconstruction.According to the cluster random principle, the patients in two gynecological areas of a certain hospital were assigned to the experimental group or the control group, 55 cases in each group. The control group was given routine nursing.On the basis of routine nursing, systematic bladder function exercise was carried out in the test group. The intervention time was 3 days before operation until the extubation of urinary catheter was successfully voided. The responsible nurses collected and recorded the replacement rate of urinary catheter and the incidence of urinary retention in the two groups after intervention.Urethral catheter retention time, residual urine volume, urine routine results, body temperature, incidence of bladder irritation and urinary tract infection.All the data were processed by SPSS 21. 0 statistical software.T test was used to compare the measurement data of the two groups, and 蠂 2 test and fisher's exact probability method were used to compare the count data.The result is 1: 1.There were 12 patients in the test group with a resetting rate of 21.82 urinary catheter and 23 patients in the control group. The replacement rate was 41.82%.The difference of urethral replacement rate between the two groups was statistically significant (P 0.05, 蠂 2 = 7.880, P < 0.05).A total of 13 patients in the trial group were confirmed to have urinary retention, with an incidence of 23.64 and 38.18 in the control group.The results showed that the incidence of urinary retention in the two groups was significantly higher than that in the control group (P 0.05, 蠂 2 = 6.714, P < 0.05).The indwelling time of urethral catheter in the test group was 55.14 19.53 and that in the control group was 64.58 21.60 and 2.334g / P 0.05, the difference was statistically significant, and the urinary residual volume was 20.45 27.00 and 30.55 25.44 / 2.017 / P0.05 respectively, which indicated that this method could effectively reduce the retention of urine.The incidence of bladder irritation in the control group (n = 19) was higher than that in the test group (n = 13). The rate of bladder irritation was 34.55 in the control group and 23.64 in the test group.But the analysis found no significant difference between the two groups. 5. 5.The incidence of urinary tract infection in the test group was lower than that in the control group (17.02%). The main judgment method was the number of white blood cells in the urine sediment microscopic examination, but there was no significant difference between the two groups.Conclusion: systematic bladder function training has a good effect on preventing urinary retention after pelvic floor reconstruction. Although it is not effective in preventing urinary tract infection and reducing bladder irritation symptoms, it can reduce the replacement rate of urinary catheter.It is of great significance to shorten the indwelling time of urethral catheter and improve the quality of life of patients.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.6

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