原位回结肠新膀胱术后患者恢复程度与腹压变化的相关性研究

Correlation study of recovery degrees and intra-abdominal pressure changes for patients after ilealcolon neobladder surgery

目的:探讨原位回结肠新膀胱术后患者恢复程度与腹内压变化的相关性研究,以指导护理工作,防止并发症。方法:对60例患者根据UBP不同分为实验组和对照组,行膀胱全切、原位回结肠代膀胱术后患者进行UBP与生命体征、术后恢复程度观察指标的监测。结果:实验组患者胃肠功能恢复明显优于对照组,两组患者MP比较差异无统计学意义(t=1.64,P>0.05),心率、呼吸频率、疼痛三个指标,两组比较差异有统计学意义(P<0.05);腹内压与术后恢复患者各项指标采用相关性分析显示,两组患者腹内压与肠鸣音恢复时间、肛门排气时间、心率、呼吸频率、疼痛呈正相关,与每日进食量、实验组患者平均动脉压呈负相关(P<0.05),对照组患者腹胀、并发症发生率高于实验组,差异有统计学意义(P<0.05)。结论:原位回结肠新膀胱手术后恢复与腹内压变化有密切关系。UBP监测腹内压,是观察原位回结肠新膀胱手术后患者病情及手术后恢复程度的好方法。

Objective：To perform a correlation study of recovery degrees and intra-abdominal pressure changes for patients af-ter ilealcolon neobladder surgery, so as to guide the nursing works and prevent complications. Methods：60 cases were divided into ex-perimental group and control group based on different UBP and suffered from bladder hysterectomy and ilealcolon neobladder surgery. Then, their UBP, vital signs, postoperative recovery degrees were observed and monitored. Results： The gastrointestinal functional re-covery of experimental group was significantly better than that of control group, and there was no difference in MP between the two groups （t=1. 64, P〉0. 05）. There were differences in heart rate, breathing rate, and pains between the two groups （P〈0. 05）. The correlation analysis for the intra-abdominal pressure and postoperative recovery indices of the two groups showed that the intra-abdomi-nal pressure was positively correlated with bowel sounds recovery time, anus exhaust time, heart rate, breathing rate, and pains, but was negatively correlated with daily food intake; and the intra-abdominal pressure was also negatively correlated with the mean arterial pressure （P〈0. 05）. The incidence rates of abdominal distention and complications of control group were higher than those of experi-mental group, and there were statistical difference between the two groups. Conclusions： After the ilealcolon neobladder surgery, the recovery is closely related with the intra-abdominal pressure changes. Therefore, UBP for monitoring the intra-abdominal pressure is a good method for observing the patients＇ conditions and recovery degrees after the surgery.