新型拔管方法在老年男性患者留置导尿中的循证护理实践

The evidence-based nursing practice of the new method of catheter extubation in the elderly male patients with urinary calculi with indwelling catheter

目的初步探讨新型与传统拔尿管方式在留置导尿中的应用效果。方法回顾性分析2018年2月至9月郑州大学附属洛阳中心医院泌尿外科50例留置导尿男性中老年结石患者,试验组和对照组各25例,比较两组患者年龄、留置尿管时间、尿管拔除后首次排尿尿道疼痛状况及拔除尿管时舒适度情况。结果试验组25例患者,平均年龄为72.72±10.819岁,留置尿管时间为118.32±29.310h,拔除尿管患者不舒适患者有1例(4%),首次排尿无疼痛和轻度疼痛患者为17例(68%),试验组无尿潴留患者。对照组25例患者,平均年龄为70.72±10.208岁,留置尿管时间为120.24±23.74h,拔除尿管不舒适患者有5例(20%),首次排尿无疼痛和轻度疼痛患者为12例(48%),对照组有4例尿潴留患者(16%)。两组比较单因素分析示年龄(P=0.505)、留置导尿时间(P=0.800)无统计学差异;拔除尿管患者舒适度(P=0.028)、首次排尿疼痛程度(P=0.036)、尿潴留(P=0.015)两组有统计学差异。结论相比普通拔管方式,新型拔管方式可以更好地减轻患者首次排尿尿道疼痛状况,让患者拥有更加舒适的体验。

Objective To explore the application effect of new and traditional way of urinal extubation in the stone patients of middle-aged and old men with indwelling catheterization.Methods A retrospective analysis of 50 cases of male middle-aged and elderly calculi patients with urinary catheterization in the department of urology,luoyang central hospital affiliated to zhengzhou university from 2018-2 to 2018-9 was conducted,including 25 cases in the experimental group and the control group.Results The average age of the 25 patients in the experimental group was 62.72±10.819,the indwelling time was 118.32±29.310 h,1 patient(4%) was uncomfortable with the removal of the urinary tube,and 17 patients(68%) were painless and mild with the first urination.In the experimental group,there was no urinary retention.The mean age of the 25 patients in the control group was 60.72±10.208,and the indwelling time was 120.24±23.74 h.There were 5 patients(20%) with uncomfortable removal of the catheter,12 patients(48%) with no pain or mild pain in the first urination,and 4 patients(16%) with urinary retention in the control group.Univariate analysis showed no statistically significant differences in age(P=0.505) and indwelling catheter time(P=0.800) between the two groups.There were statistically significant differences between the two groups in comfort(P=0.028) and first urination pain(P=0.036).Conclusion Compared with the common way of catheter extubation,the new way of catheter extubation can better alleviate the pain of patients’ first urination and urethra,so that patients have a more comfortable experience.