微信网络支持系统在肠道膀胱扩大术后患者延续护理中的应用

Effects of WeChat online support system on continued nursing care for patients receiving enteral bladder augmentation

目的建立肠道膀胱扩大术后患者延续护理微信网络支持系统,评估该系统在脊髓损伤神经源性膀胱行肠道膀胱扩大术后患者延续护理中的应用效果。方法采用便利抽样法,选取2016年3月—2018年3月在浙江省人民医院出院的脊髓损伤神经源性低顺应性膀胱行肠道膀胱扩大术后患者60例为研究对象。按就诊编号采用随机数字表分为观察组和对照组各30例。对照组采用常规出院后延续护理,观察组通过微信网络支持系统提供出院后延续护理,回访时间均为3个月。比较两组患者出院时和出院3个月后自我膀胱管理依从性、尿管相关并发症、膀胱功能、生活质量和负性情绪。结果干预3个月后,观察组患者自我膀胱管理依从性、焦虑评分、抑郁评分及生活质量中的身体功能、角色功能、情绪功能、社会功能等均优于对照组(P<0.05);观察组的尿路感染和尿道损伤分别为3.3%和6.7%,而对照组则为26.7%和33.3%,观察组尿管相关并发症发生率低于对照组(P<0.05);观察组的膀胱功能中的膀胱容量、膀胱顺应性、残余尿量、最大逼尿肌压力等参数均优于对照组(P<0.05)。结论微信网络支持系统可提高出院患者自我膀胱管理依从性,降低尿管相关并发症,促进膀胱功能恢复,改善患者的负性情绪,提高生活质量。

ObjectiveTo establish a WeChat online system supporting continued nursing care for patients receiving enteral bladder augmentation and to evaluate its effects on continued nursing care for patients with neurogenic bladder in spinal cord injury who received enteral bladder augmentation.MethodsTotally 60 patients with low-compliant neurogenic bladder in spinal cord injury who received enteral bladder augmentation and were discharged from Zhejiang Provincial People's Hospital between March 2016 and March 2018 were selected by convenient sampling,and divided into the observation group(n=30)and the control group(n=30)according to the random number table.Patients in the control group received conventional nursing care after discharge,while patients in the observation group received nursing care after discharge via the WeChat online support system.The follow-up duration was 3 months.Bladder self-management compliance,urinary catheter-associated complications,bladder function,quality of life and negative emotions at discharge and 3 months after discharge were compared between the two groups.ResultsThe score of bladder self-management compliance,anxiety score,depression score,and scores of physical function,role function,emotional function and social function in quality of life in the observation group were better than those in the control group 3 months after discharge(P<0.05);the rates of urinary tract infection and urethral injury of the observation group were 3.3%and 6.7%,while those of the control group were 26.7%and 33.3%,respectively;the incidence rate of urinary catheter-associated complications of the observation group was lower than that of the control group(P<0.05);and the parameters of bladder function such as bladder volume,bladder compliance,residual urine volume and maximum detrusor pressure of the observation group were better than those of the control group(P<0.05).ConclusionsThe WeChat online support system can improve patients'bladder self-management compliance,reduce the urinary catheter-associated complications,enable the recovery of bladder function,ameliorate their negative emotions,and improve their quality of life.