盆底肌群训练对宫颈癌术后尿潴留干预的效果观察

Effect of pelvic floor muscle training on nursing intervention for urinary retention after cervical cancer surgery

目的探讨盆底肌群训练对宫颈癌患者行广泛全子宫切除+盆腔淋巴结清扫术后发生尿潴留并发症的影响。方法将2014年2月—2015年4月在肿瘤妇科行广泛全子宫切除+盆腔淋巴结清扫术治疗的宫颈癌患者126例,按入院先后顺序分为对照组和实验组。对照组给予常规宣教和护理及加强尿管护理;实验组除按对照组的护理外,分别在手术前和手术后采取一对一辅导的方法指导患者进行盆底肌群训练,术后2组患者留置导尿管均14 d拔除。结果对照组患者的尿潴留发生率43.6%,明显高于实验组患者发生率14.08%,P<0.05,差异有统计学意义。结论针对宫颈癌行广泛全子宫切除+盆腔淋巴结清扫术的患者进行术前盆底肌群训练指导和术后有意识的进行盆底肌群训练,调整患者因长期留置尿管担心排尿不畅的紧张心理,使其重新利用会阴、盆底肌群的协调压力,再次促进尿液排空,可以有效的预防宫颈癌术后发生尿潴留,而且此方法简单、安全易行,值得在临床上推广。

Objective To explore the effect of pelvic floor muscle training on decreasing the incidence of urinary retention after total hysterectomy and pelvic lymph node dissection in patients with cervical cancer. Methods Total 126 eases of cervical cancer undergoing total hysterectomy and pelvic lymph node dissectionin our ward from February 2014 to April 2015 were divided into control group and experimental group according to the inpatients admission order. The control group was given routine health education, nursing and the urine catheter care;The experimental group received one-on-one pelvic floor muscle training before and after the operation in addition to routine care. The catheters in both groups were removed 14 days later. Results The incidence of urinary retention in the control group was 43.6%, which was significantly higher than 14.08% in the experimental group （ P 〈 0.05 ）, the difference was statistically significant. Conclusion For patients who received total hysterectomy and pelvic lymph node dissection, the preoperative guidance and postoperative exercise about pelvic floor muscle training,psychological care to adjust their worry about the placement of a urinary catheter for a long time,promotion of bladder emptying exercises will effectively prevent urinary retention after the surgery for cervical cancer. This treatment method is simple,safe and easy to operate,thus it is worth popularizing in clinical nursing.