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        前列腺術(shù)后膀胱痙攣的高危因素及臨床護理措施分析

        發(fā)布時間:2018-06-23 來源: 歷史回眸 點擊:


          [摘要]目的 分析前列腺術(shù)后膀胱痙攣的高危因素,探討臨床護理措施。方法 選擇2016年1~12月在我院行經(jīng)尿道前列腺電切術(shù)治療前列腺增生患者162例,依照術(shù)后膀胱痙攣發(fā)生與否分為發(fā)生組(n=61)與未發(fā)生組(n=101),對比兩組患者相關(guān)指標,分析膀胱痙攣發(fā)生的高危因素,針對性地制定臨床護理措施。結(jié)果 經(jīng)分析,發(fā)生組患者焦慮評分(SAS)≥50分、低順應(yīng)性膀胱和(或)不穩(wěn)定膀胱、尿管氣囊注水體積40 ml、沖洗液未加溫占比均高于未發(fā)生組,差異有統(tǒng)計學(xué)意義(P<0.05);經(jīng)Logistic多因素分析結(jié)果顯示,SAS評分、低順應(yīng)性和/或不穩(wěn)定膀胱、沖洗液加溫、尿管氣囊注水為高危因素(P<0.05)。結(jié)論 前列腺術(shù)后膀胱痙攣的高危因素較多,臨床應(yīng)針對高危因素實施護理,促使患者盡早痊愈出院。
          [關(guān)鍵詞]前列腺術(shù);膀胱痙攣;高危因素;臨床護理
          [中圖分類號] R473.6 [文獻標識碼] A [文章編號] 1674-4721(2018)2(b)-0179-03
          Risk factors of bladder spasm after prostatectomy and analysis of clinical nursing measures
          HUANG Xiao-huan WANG Wen-cai
          Department of Urology,People′s Hospital of Huadu District of Guangzhou City,Guangdong Province,Guangzhou 510800,China
          [Abstract]Objective To analyze the risk factors of bladder spasm after prostatectomy,explore the clinical nursing measures.Methods 162 patients with benign prostatic hyperplasia from January to December 2016 in our hospital underwent transurethral resection of the prostate,patients divided into happen group (n=61) and without group (n=101) according to with or without postoperative bladder spasm,related indicators were compared between two groups,analysis of risk factors of bladder spasm,to make the clinical nursing measures.Results After analysis,group SAS was more than 50 points,low compliance bladder or (and) unstable bladder,balloon catheter injection volume 40 ml,without washing liquid heating were higher than the proportion of without group,significant difference (P<0.05);multivariate Logistic analysis showed that SAS score,low compliance and/or unstable bladder flush fluid heating,water balloon catheter was a risk factor (P<0.05).Conclusion The prostate surgery the risk factors of bladder spasm after more clinical nursing according to the risk factors,prompting patients as early as possible recovery.
          [Key words]Prostate operation;Bladder spasm;High risk factors;Clinical nursing
          前列腺增生為臨床常見的前列腺疾病類型之一,主要采用經(jīng)尿道前列腺電切術(shù)治療,具有較好的手術(shù)效果,但術(shù)后較易發(fā)生的并發(fā)癥為痙攣,表現(xiàn)為下腹部陣痛或持續(xù)性疼痛出現(xiàn)在導(dǎo)尿管留置期間,伴有急迫的尿意感與便意感,尿道口會溢出尿液,顏色加深變紅現(xiàn)象明顯,緩解疼痛后,可經(jīng)導(dǎo)尿管排出尿液[1]。前列腺術(shù)后并發(fā)膀胱痙攣后,使患者身心均承受巨大的痛苦,因此,臨床一直注重該術(shù)后并發(fā)癥的防治,而防治措施有效制定的前提條件為準確掌握其發(fā)生的高危因素[2]。因此,本研究回顧性分析了行電切術(shù)治療的前列腺增生患者的資料,總結(jié)術(shù)后膀胱痙攣發(fā)生的高危因素,為臨床預(yù)防提供參考。
          1資料與方法
          1.1一般資料
          選擇我院2016年1~12月行經(jīng)尿道前列腺電切術(shù)治療的前列腺增生患者162例,年齡47~81歲,平均(58.3±3.7)歲;病程7個月~22年,平均(10.5±4.0)年;前列腺重量29~107 g,平均(62.8±28.5)g。納入標準[3]:①符合前列腺增生的診斷標準;②具有經(jīng)尿道前列腺電切術(shù)的適應(yīng)證,無絕對禁忌證;③本研究經(jīng)我院醫(yī)學(xué)倫理委員會批準;④患者病歷資料齊全,且知情同意;⑤排除伴下尿路創(chuàng)傷史、神經(jīng)系統(tǒng)疾病患者。
          1.2方法
          收集所有患者病歷資料,對其行回顧性分析,依照術(shù)后膀胱痙攣發(fā)生與否,將患者分為發(fā)生組(n=61)與未發(fā)生組(n=101),統(tǒng)計、比較兩組患者相關(guān)資料,包含年齡(≥65歲)、前列腺癥狀評分(IPSS,≥20分)、生活質(zhì)量指數(shù)(QOL,≥3.5分)、焦慮自評量表(SAS,≥50分)、切除前列腺體積(>20 ml)等,分析引發(fā)術(shù)后膀胱痙攣的高危因素。針對高危因素分析結(jié)果,結(jié)合文獻資料,制定臨床護理措施。

        相關(guān)熱詞搜索:膀胱 術(shù)后 前列腺 痙攣 臨床

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