不同护理方法对食管癌术后留置尿管患者的临床效果对比

Effect of different nursing on esophageal carcinoma patients with indwelling catheter after surgery

目的:比较食管癌术后留置导尿后采取不同拔管方法与患者自主排尿困难发生率、再次导尿率、尿路刺激征发生率和程度的关系。方法:按入院时间的先后次序将研究对象随机分成观察组和对照组各50例,观察组患者术后均间隔2～3h开放尿管1次,在拔除尿管前先夹闭尿管,待患者有明显尿意,同时体检显示膀胱中度以上充盈时拔除尿管;对照组在术后一直开放尿管,拔尿管前仍先排空膀胱内尿液后直接拔除。以拔除尿管后自主排尿发生率、再次导尿发生率以及尿路刺激征发生率和程度作为两种不同护理方法临床效果的评价指标。结果:观察组拔尿管后排尿困难发生率和再次导尿率明显低于对照组(P<0.05),尿路刺激征发生率无明显差异。结论:食管癌患者留置导尿期间定时开放尿管和拔除尿管前先夹闭尿管,待患者有尿意、膀胱充盈时再拔除尿管,可以显著降低患者自主排尿困难发生率和再次导尿发生率,有利于患者术后自主排尿功能的恢复。

Objective： To compare the effect of different nursing on esophageal carcinoma patients with indwelling catheter after surgery.Methods： Patients were randomly divided into observation group and control group with 50 cases in each group according to the time of admission.The urinary catheter of patients in observation group was open every 2-3 h after surgery.Before removing the urinary catheter,it would be occluded first.When patients had the urge to urinate and physical examination revealed moderate bladder filling,the urinary catheter was then pulled out.The urinary catheter of control group remained opening.After removing the urine in their bladder,the extubation was performed.The incidence of automatic micturition after removing the catheter,the incidence of re-catheterization,and the frequency and extent of urinary irritation were observed to evaluate the clinical efficacy of two different approaches of nursing.Results： The observation group showed significantly lower incidence of automatic micturition and re-catheterization as compared with the control group（P0.05）.There was no significant difference in the incidence of urinary irritation.Conclusions：Opening the urinary catheter on time,occluding catheter before removing the tube,and performing extubation when patients have the urge to urinate and physical examination reveals moderate filing of the bladder,can significantly reduce the incidence of automatic micturition and re-catheterization and can assist the recovery of automatic micturition function.