全程康复路径护理在SUI患者TVT-O围术期中的应用

Application of whole-course rehabilitation nursing in perioperative period of TVT-O in patients with SUI

目的探讨经闭孔尿道中段无张力吊带悬吊术(TVT-O)围术期全程康复路径护理对女性压力性尿失禁(SUI)患者术后疗效的影响。方法选取滕州市中心人民医院2011年1月至2016年6月行TVT-O患者84例。回顾性分析SUI患者临床资料,根据护理方案不同分为观察组(43例)及对照组(41例)。对照组行常规入院宣教及术前评估,观察组采取围术期全程康复路径护理方案。在围术期及术后护理指导3个月后,分别采用国际尿失禁咨询委员会尿失禁问卷表简表(ICI-Q-SF)评价患者尿失禁的严重程度。比较两组患者漏尿情况,包括漏尿次数、漏尿量、膀胱残余尿量及ICI-Q-SF量表评分,采用焦虑自评量表(SAS)和抑郁自评量表(SDS)对患者进行评估。结果观察组治疗后ICI-Q-SF总分,漏尿次数和漏尿量显著低于对照组,控尿效果较对照组更为理想;观察组患者SDS、SAS评分明显低于对照组,差异有统计学意义(P<0.05)。结论围术期全程康复路径护理使患者术后ICI-Q-SF总分、漏尿次数和漏尿量显著减低,改善了盆底肌肉功能。

Objective To investigate the effect of perioperative whole rehabilitation path nursing for female patients with stress urinary incontinence(SUI)after transobturator tension-free vaginal tape(TVT-O)in the middle section of the mesobturator urethra.Methods Eighty-four patients who underwent TVT-O from January 2011 to June 2016 in this hospital were selected as the research subjects.Clinical data of SUI patients were retrospectively analyzed and divided into observation group(43 cases)and control group(41 cases)according to different nursing plans.The control group received routine admission education and preoperative evaluation,while the observation group received perioperative rehabilitation path nursing plan.The severity of SUI was assessed using the International Urinary Incontinence Advisory Committee Urinary Incontinence Questionnaire Short Form(ICI-Q-SF)during the perioperative period and after 3 months of postoperative nursing guidance.The urine leakage,including the number of urine leakage,urine leakage volume,bladder residual urine volume and ICI-Q-SF scale score,were compared between the two groups.The patients were evaluated by the Self-Rating Anxiety Scale(SAS)and the Self-Rating Depression Scale(SDS).Results After treatment,the total score of ICI-Q-SF,the number and volume of urine leakage in the observation group were significantly lower than those in the control group,and the effect of urine control was better than that in the control group.SDS and SAS score in observation group was significantly lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusions The perioperative whole rehabilitation path nursing significantly reduced the total score of ICI-Q-SF,the number and volume of urine leakage,and improved the pelvic floor muscle function.