舒适护理干预对经尿道前列腺等离子电切术患者心理状态、术后疗效及并发症的影响

Effect of comfortable nursing intervention on mental state, postoperative curative effect and complication of patients treated with transurethral plasmakinetic resection of the prostate

目的探讨舒适护理干预对经尿道前列腺等离子电切术(PKRP)患者心理状态、术后疗效及并发症的影响。方法 160例行PKRP治疗患者随机分为舒适护理组和常规护理组,常规护理组在PKRP围手术期予以常规护理,舒适护理组在此基础上予以围手术期舒适护理。结果术后5 d两组患者的SAS和SDS评分均较术前明显下降(P<0.01或P<0.05),且舒适护理组下降幅度与对照组比较更明显(P<0.05);舒适护理组术后膀胱痉挛发生率、术后膀胱冲洗时间、术后留置尿管时间和术后住院时间均明显少于常规护理组(P<0.05或P<0.01),术后并发症的发生率明显低于常规护理组(χ2=7.89,P<0.01)。同时术后3个月,两组患者IPSS评分和RU均较术前明显下降,Qmax和QOL评分均较术前明显上升(P<0.05或P<0.01),且观察组下降或上升幅度较对照组较明显(P<0.05)。结论舒适护理干预可明显改善行PKRP治疗患者的心理状态,缩短术后膀胱冲洗、留置尿管时间及住院时间,减少膀胱痉挛及并发症的发生率,提高手术的疗效;并能改善下尿路梗阻症状,减少残余尿量,增加尿流率,提高患者的生活质量。

Objective To discuss the effect of comfortable nursing intervention on mental state, postoperative curative effect and complication of patients treated with transurethral Plasmakinetic Resection of the Prostate（PKRP）. Methods A total of 160 cases PKRP patients were divided into comfortable nursing group and ordinary nursing group. The pa- tients in ordinary nursing group were treated with ordinary nursing during PKRP perioperative period,however, the patients in comfortable nursing group were treated with both ordinary nursing and comfortable nursing during PKRP perioperative period. Results After five postoperative days, SAS and SDS scores of patients in two groups had obvious- ly declined than before（P 〈 0.01 or P 〈 0.05）, and the decline rate in comfortable group was much higher than that in control group （P 〈 0.05）. Compared with patients in ordinary nursing group, the incidence rate of postoperative cystospasm of patients in comfortable nursing group was obviously lower, as well as the postoperative washing time of urinary bladder, the time of postoperative indwelling catheter, and the postoperative length of stay （P 〈 0.05 or P 〈 0.01 ）, what＇s more, the incidence rate of postoperative complication was obviously lower as well （X2=7.89,P 〈 0.01 ）. Mean- while, after 3 postoperative months, IPSS and RU scores of patients in two groups had declined obviously than be- fore, and Qmax and QOL scores had risen obviously than before（P 〈 0.05 or P 〈 0.01 ）, whichever rising or declin- ing rate was much more obvious than those in control group （P 〈 0.05）. Conclusion Comfortable nursing intervention has obvious effect on the mental state of PKRP patients, shorten the time of postoperative washing of urinary bladder, indwelling catheter, and length of stay, reduce the incidence rate of cystospasm and complication and improve the curative effect. Moreover, comfortable nursing intervention can improve tract obstruction of lower urinary, reduce residual urine volume （RUV）, strengthen urine flow rate and enhance the quality of patients＇ life.