开关散穴位烫疗治疗术后膀胱功能障碍的临床研究

Acupuncture point-hot treatment with Kaiguan powder for postoperative bladder dysfunction

目的探讨椎管内麻醉术后膀胱功能障碍的有效护理方法。方法将60例符合纳入标准的膀胱功能障碍患者按随机分配原则分为实验组和对照组，每组30人。实验组采用开关散穴位烫疗法：用中药散烫疗中极、关元、曲骨、阴陵泉、三阴交、足三里穴位，连续治疗至膀胱功能恢复。对照组常规留置导尿管，进行导尿管护理，每24h测试1次患者初尿意、膀胱内压、残余尿量，如达到正常值水平，则膀胱功能恢复，拔除导尿管。比较两组导尿管留置时间、泌尿系统感染率、尿急尿痛改善情况以及患者主观满意度。结果实验组导尿管留置时问明显少于对照组[（2．70±0．49）dVS．（4．30±0．74）d，t=4．233，P〈0．001]；实验组泌尿系统感染发生率明显低于对照组（3例VS．7例，Fisher确切概率法，P=-0．033）；实验组尿急尿痛改善情况以及患者主观满意度与对照组比较，差异均有统计学意义（P均〈0．05）。结论中药穴位烫疗疗法可加快椎管内麻醉术后膀胱功能的恢复，促进患者术后康复。

Objective To investigate an effective nursing method for bladder dysfunction induced by intraspi- nal anesthesia. Methods 60 patients with bladder dysfunction who met the selection criteria were randomly divided into study group and control group, 30 for each group. The study group received acupuncture point-hot treatment with Kaiguan powder to heat Zhongji, Guanyuan, Qugu, Yinlingquan, Sanyinjiao, and Zusanli until restoration of bladder function. The control group received routine indwelling catheter and care for the catheter. The initial urine intention, bladder pressure, and residual urine volume were tested every 24 hours. Normal levels of bladder pressure and residual urine volume revealed restoration of bladder function, and the urinary catheter could be removed. Duration of catheter placement, rate of urinary tract infection, improvement in urgent micturition and urodynia, and patient satisfaction were compared between the two groups. Results Duration of catheter placement was shorter in the study group than in the control group （ t = 4.233, P 〈 0.001 ）; the rate of urinary tract infection was significantly lower in the study group than in the control group （ Fisher exact probability, P= 0.033 ） ; improvement in urgent micturition and urodynia and patient satisfaction differed statisti- cally （ P 〈 0.05 ）. Conclusions Acupuncture point-hot treatment with Chinese medicine can accelerate restoration of of bladder function induced by intraspinal anesthesia, promoting postoperative rehabilitation in patients.