妇科肿瘤根治术后尿潴留集束化护理措施的构建与应用

Construction and application of cluster nursing measures for urinary retention after gynecological tumor radical operation

目的构建妇科肿瘤根治术后尿潴留集束化护理措施,探讨妇科肿瘤根治术后尿潴留的预防方法。方法成立妇科康复护理小组,查阅国内外文献,对有效解决尿潴留的关键措施进行Meta分析,设计制作一套妇科肿瘤根治术术后尿潴留集束化护理措施。本研究采取前后对照研究方法,选取2016年1月—2017年6月在深圳大学第一附属医院妇科病房治疗的54例患者作为对照组,2017年7月—2018年8月的52例患者作为试验组。对照组实施妇科常规护理措施,试验组在常规护理的基础上实施集束化护理措施。采用观察记录表收集资料,表中内容包括患者实施情况与肢体活动度效果观察。每天观察患者排尿中断训练、盆底肌功能训练、踝泵运动和胸腹综合体操的执行时间、频率以及未使用原因,拔管时饮水试验及间歇性清洁自助导尿术(CISC)的使用情况。采用SPSS 21.0进行数据的处理和分析。结果试验组患者52例发生尿潴留1例,发生率为1.92%,延迟拔管2例,总并发症发生率5.77%(3/52);对照组患者54例发生尿潴留5例,发生率为9.26%,延迟拔管6例,总并发症发生率20.37%(11/54)。两组患者并发症发生率比较,差异有统计学意义(P<0.05)。结论该集束化护理措施是多项有效措施的组合,临床使用结果证明能有效预防妇科肿瘤根治术术后尿潴留的发生。

Objective To develop cluster nursing measures for urinary retention after gynecological tumor radical operation,and explore the prevention methods of urinary retention after gynecological tumor radical operation.Methods We established a gynecological rehabilitation nursing team,retrieved domestic and foreign literature,conducted a Meta-analysis on the key measures to effectively treat urinary retention,and designed and developed a set of cluster nursing measures for urinary retention after radical gynecological tumor surgery.A controlled trail was conducted in this study.Totally 54 patients treated in the gynecological ward of the First Affiliated Hospital of Shenzhen University from January 2016 to June 2017 were selected as the control group,while another 52 patients treated from July 2017 to August 2018 were selected as the experimental group.Patients in the control group received routine gynecological nursing,while patients in the experimental group received cluster nursing based on routine nursing.Data were collected using an observation record form,which included observations of patients'practice and limb mobility effects.The execution time and frequency of urinary interruption training,pelvic floor muscle function training,ankle pump exercise and thoraco-abdominal gymnastics,and the reasons for not using them,drinking test at extubation and intermittent clean self catheterization(CISC).Data were processed and analyzed using SPSS 21.0.Results One out of the 52 patients in the experimental group had urinary retention,accounting for an incidence rate of 1.92%,delayed extubation occurred in 2 cases,with a total complication rate of 5.77%(3/52);while 5 out of the 54 patients in the control group had urinary retention,accounting for an incidence rate of 9.26%,delayed extubation occurred in 6 cases,with a total complication rate of 20.37%(11/54).There was a statistically significant difference in the incidence of complications between the two groups(P<0.05).Conclusions The cluster nursing measures are a combination of multiple effective measures,and the clinical application results have shown that they can effective prevent the occurrence of urinary retention after gynecological tumor radical surgery.