经尿道等离子气化电切膀胱肿瘤术术后痉挛原因分析及应对干预

Analysis the Causes for Bladder Spasm after Transurethral Resection of Bladder Tumor and Their Nursing Strategies

目的研究经尿道等离子气化膀胱肿瘤电切术后膀胱痉挛发生的原因和护理措施。方法采用观察法对110例经尿道膀胱肿瘤电切术的病人进行观察,分析膀胱痉挛的原因,及时给予对症处理。结果110例经尿道膀胱肿瘤电切术后62例出现膀胱痉挛。其主要原因有(1)病人的心理状况,占86.45%;(2)术后出血创面组织脱落使引流管堵塞、引流管折叠、扭曲、固定不妥当,占45.15%;(3)导管刺激,占24.83%;(4)冲洗液的温度、速度,占14.51%;(5)腹压增高,占9.67%;(6)膀胱及尿道感染,占1.6%。结论术前做好心理护理、术后做好管道的护理及病情观察是预防术后膀胱痉挛发生的关键。

Objective To study causes for bladder spasm after transurethral resection of bladder tumor （PKRBt） and discuss nursing strategies. Methods 110 patients who received PKRBt were observed; postoperative discomforts were recorded; causes for bladder spasm were analyzed, and in - time treatment was provided. Results In the 110 patients, 62 patients reported bladder spasm. The main causes were summarized as follows; 1 ） Patients ＇psychological situation, accounting for 86. 45% ; 2） Impotency of the drainage tube because of postoperative hemorrhage, or because of tube folding, distortion or displacement, accounting for 45. 15% ; 3） Direct stimulation from drainage, accounting for 24. 83% ; 4） Temperature, and speed of rinsing fluid, accounting for 15. 0% ; 5） Rise in abdominal pressurc, accounting for 9.67% ; and 6） Infection of bladder and urethra, accounting for 1.6%. Conclusion The most important thing to prevent bladder spasm is good psychological education, suitable rinsing of drainage and close observation of patients＇conditions.