经尿道膀胱肿瘤电切术后膀胱冲洗堵管的危险因素分析与集束化干预策略

Analysis of risk factors of bladder irrigation and tube blocking after transurethral resection of bladder tumor and intervention strategy of cluster

目的探讨经尿道膀胱肿瘤电切术后膀胱冲洗堵管的危险因素,基于危险因素制定集束化干预策略,观察集束化干预策略在预防膀胱冲洗堵管的效果。方法对2021年6月至2022年6月南京医科大学第一附属医院收治的108例经尿道膀胱肿瘤电切术后行膀胱冲洗患者的临床资料进行回顾性分析。进行堵管相关性分析,基于危险因素制定集束化干预策略,比较堵管等冲洗相关不良事件发生率。结果焦虑自评量表评分、开始冲洗时间、冲洗液温度、冲洗速度、膀胱痉挛是膀胱冲洗堵管发生的危险因素,差异有统计学意义(P<0.05)。Logistic回归模型结果显示,冲洗液温度、冲洗速度、膀胱痉挛是堵管发生的独立危险因素(P<0.05)。采用集束化策略干预后,膀胱冲洗堵管发生率为20.37%(22/108),低于干预前的38.89%(42/10),差异有统计学意义(P=0.01)。结论集束化干预策略能够有效降低膀胱冲洗堵管发生率。

Objective To investigate the risk factors of bladder irrigation tube blockage after transurethral resection of bladder tumors,and to develop cluster intervention strategies based on the risk factors and observe the effect of cluster intervention strategies in preventing bladder irrigation tube blockage.Methods The clinical data of 108 patients who underwent bladder irrigation after transurethral resection of bladder tumors in The First Affiliated Hospital of Nanjing Medical University from June 2021 to June 2022 were retrospectively analyzed.Correlation analysis of tube blockage was performed,cluster intervention strategies were developed based on risk factors,and the incidence of rinse-related adverse events such as tube blockage was compared.Results Self-rating anxiety scale score,start time of flushing,flushing fluid temperature,flushing speed,bladder spasm were the risk factors of bladder flushing tube blockage,the differences were statistically significant(P<0.05).Logistic regression model showed that flushing fluid temperature,flushing speed and bladder spasm were independent risk factors for tube blockage(P<0.05).After the intervention of the cluster strategy,the incidence of bladder irrigation tube blockage was 20.37%(22/108),which was lower than 38.89%(42/10)before the intervention,and the difference was statistically significant(P=0.01).Conclusion The cluster intervention strategy can effectively reduce the incidence of bladder irrigation tube blockage.