延伸护理在军事训练致尿道损伤男性官兵中的应用效果分析

Extended nursing on male soldiers with urethral injuries related to military training

目的探讨延伸护理在军事训练致尿道损伤男性官兵中的应用效果。方法按照纳入和排除标准,收集陆军军医大学第二附属医院泌尿外科2017年1月—2022年1月收治的66例尿道损伤男性官兵资料,年龄19~26岁,平均23.1岁,兵龄1~5年。手术治疗适应证:球部远端和阴茎部的尿道完全性断裂;会阴、阴茎、阴囊形成大血肿;尿道破裂,导尿失败。非手术治疗的适应证:尿道挫伤,症状较轻,尿道连续性存在;导尿管能插入。33例出院后实施延伸护理(试验组,手术治疗16例,非手术治疗17例),具体干预措施包括:饮食建议、康复指导、复查计划、心理疏导等;33例出院后不予实施延伸护理干预(对照组,手术治疗16例,非手术治疗17例)。比较两组患者术后拔除导尿管时间、术后切口感染率、尿道狭窄率、患者依从良好率、护理满意度等指标。结果试验组和对照组非手术治疗患者导尿管拔除时间分别为(7.6±1.3)dvs.(7.8±1.8)d,差异无统计学意义(P>0.05),试验组和对照组手术治疗患者导尿管拔除时间分别为(30.1±0.4)d vs.(32.6±0.4)d,差异有统计学意义(P<0.05);试验组和对照组术后切口感染率分别为6.3%vs.18.8%,尿道狭窄率分别为18.2%vs.27.3%,差异无统计学意义(P>0.05);患者依从良好率分别为87.9%vs.63.6%,护理满意度分别为97.0%vs.75.8%,差异均有统计学意义(P<0.05)。结论在军事训练导致的尿道损伤男性官兵中实施延伸护理,可有效促进患者康复,不增加术后切口感染、尿道狭窄等并发症,提升患者的依从性和对护理工作的满意程度。

Objective To explore the effect of extended nursing on male soldiers with urethral injuries re-lated to military training.Methods According to the inclusion and exclusion criteria,data of 66 male soldiers of 19-26(mean 23.1)years old with urethral injuries admitted to the urology department of the Second Affiliated Hospital of Army Medical University from Jan.2017 to Jan.2022 were collected.The length of military service of the in-cluded cases was 1-5 years.Indications for surgical treatment were:complete rupture of the urethra at the distal end of the bulb and penis;large hematoma formed in perineum,penis and scrotum;urethral rupture and catheterization failure.Indications for non-surgical treatment were urethral contusion,mild symptoms,urethral continuity;successful catheter insertion.Among them,33 patients received extended nursing after discharge(experimental group,16 cases managed surgically and 17 not).The specific interventions for extended nursing included dietary advice,rehabilita-tion guidance,follow-up plans,psychological counseling,etc.The other 33 patients were followed up routinely with-out giving extended nursing after discharge(control group,16 cases managed surgically and 17 not).The two groups were compared in terms of time for catheter removal,infection at the incision site,rate of urethral stricture,as well as rate of good compliance and satisfactory nursing.Results The days for catheter removal for non-surgical patients was 7.6±1.3 in experimental group and 7.8±1.8 in controls,revealing no significant difference(P>0.05),but much longer for surgical patients in controls(30.1±0.4 vs.32.6±0.4,P<0.05).The postoperative rates of inci-sion site infection(6.3%vs.18.8%)and urethral stricture(18.2%vs.27.3%)showed no significant difference(both P>0.05)between experimental and control groups,but the patients􀆳compliance rate(87.9%vs.63.6%)and satisfactory nursing rate(97.0%vs.75.8%)were much higher in the experimental group(both P<0.05).Conclusion The implementation of extended nursing in male soldiers with urethral injuries following military train-ing can effectively promote their recovery without increasing the risk of developing postoperative incision infection or urethral stricture,and improve patients’compliance and satisfactory nursing.