“放-放-冲”三步改良尿管拔除模式临床应用

Clinical Application of ″Discharge-Discharge-Flush″ Three-step Modified Ureter-removing Model

目的:探讨脊柱手术后患者尿管拔除的最佳时机,最大限度减少患者尿潴留及排尿踌躇症状的发生率,缩短术后留置尿管时间。方法:将脊柱手术留置尿管的住院患者360例依据所属责任护士分管床位不同分为观察组、对照组,入组后其他术前术后护理2组相同,观察组采用"放-放-冲"三步尿管拔除模式,对照组采用患者膀胱排空后拔除尿管模式,观察2组患者排尿踌躇症状的发生率即拔管后至首次自然排尿的等待时间以及排尿舒适度、尿潴留发生率。结果:2组在拔管后患者首次自然排尿的等待时间、排尿舒适度评定及尿潴留的发生率方面比较差异具有统计学意义(P<0.01)。结论:采用"放-放-冲"三步改良尿管拔除模式可显著缩短患者首次自然排尿的等待时间,提高排尿舒适度并降低尿潴留的发生率。

Objective： To explore the best time to remove the ureter of the patients after spinal surgery, reduce the incidences of uroshisis and the symptoms of urination hesitating of the patients maximumly and shorten postoperative indwelling catheter time. Methods： All 360 inpatients were divided into the observation group and the control group according to the beds that the primary nurses took charge of. The nursing before and after the operation in both groups were same after grouping, the observation group adopted ＂discharge-discharge-flush＂ three-step modified ureter-removing model, and the control group removing ureter model after emptying the bladder, the incidence of uroshisis, urination comfort degrees, and the symptoms of urination hesitating from the waiting time of removing ureter to initial natural urination were observed in both groups. Results： The difference had statistical meaning in the comparisons of the waiting time of initial natural urination, assessment of urination comfort degrees and the incidences ofuroshisis between the observation group and the control group（P〈0.01）.Conclusion： Adopting ＂discharge-discharge-flush＂ three-step modified ureter-removing model could notably shorten the waiting time of initial natural urination, raise urination comfort degrees and decrease the incidences of uroshisis of the patients.