膀胱灌注感觉神经阻滞剂预防前列腺术后患者膀胱痉挛的疗效观察及护理  

Observation and nursing for prevention of cystospasm in patients after prostatic surgery with irrigation of resinieratoxin into urinary bladder

作　　者：李霞[1] 潘朝杰[1] 谢克基[1] 李涛[1] 

机构地区：[1]广州市第一人民医院泌尿外科,510180

出　　处：《中国实用护理杂志（下旬版）》2008年第4期23-25,共3页Chinese Journal of Practical Nursing

摘　　要：目的探讨膀胱灌注感觉神经阻滞剂（RTX）预防前列腺术后膀胱痉挛的疗效及有效护理措施。方法按住院顺序选择良性前列腺增生拟行耻骨上前列腺切除术患者20例，随机分为对照组和观察组各10例。观察组患者术前3d向膀胱灌注RTX原液4ml＋生理盐水100ml；对照组患者术前3d向膀胱灌注生理盐水104ml。术后观察记录2组拔除导尿管和膀胱造瘘管前膀胱痉挛的频率、强度（疼痛视觉模拟评分，VAS）、持续时间，膀胱冲洗液颜色转清时间，拔除导尿管和膀胱造瘘管后1，2,4周的国际前列腺症状评分及生活质量评分。结果观察组与对照组患者术后膀胱痉挛发生率分别为20％和80％。冲洗液转清时间分别为（2．8±1．7）d和（5．2±1．0）d，造瘘管留置时间为（4．0±1．6）d和（5．8±1．1）d，导尿管留置时间为（913±1．3）d和（11．8±1．1）d，VAS为（2．3±1．3）分和（4．6±1．1）分，差异均有统计学意义（P〈0．05）。观察组与对照组患者拔除导尿管和膀胱造瘘管1,2,4周后的国际前列腺症状评分分别为（11．1±3．3）分和（16．0±3.0）分，（9．5±14）分和（12．7±3．2）分，（84±1．6）分和（11．3±2．7）分，差异均有统计学意义（P〈0．05）。观察组与对照组患者拔除导尿管和膀胱造瘘管4周后的生活质量评分分别为（1．6±0．5）分和（Z8±0.9）分，差异有统计学意义（P〈0．01）。结论术前膀胱灌注RTX能降低前列腺术后膀胱痉挛的发生率和严重程度。规范化膀胱灌注及严密病情观察，保持术后膀胱冲洗通畅是使RTX灌注发挥最大疗效的重要护理措施。Objective To discuss the treatment and nursing effect for prevention of cystospasm in patients after prostatic surgery with irrigation of resinieratoxin （RTX） into urinary bladder. Methods Twenty patients were divided into the control group and observation group with 10 cases in each group according to the date of hospitalization.Four milliliters of RTX and 100 ml of normal saline were irrigated into the bladder 3 days before operation in the observation group.Only 104 ml normal saline was irrigated into the bladder in the control group.The frequency,intension and duration of cystospasm and clearing time of bladder flushing fluid were observed.The international prostatic symptom score （IPSS） and score of life quality were evaluated at the first, second and 4th week after removing of urinary catheter and bladder stoma. Results The outcome in the observation group and the control group were as followed： the incidence rate of cystospasm was 20% and 80%, the clearing time of bladder flushing fluid was （2.8±1.7）d and （5.2±1.0）d,the indwelling time of bladder stoma was （4.0±1.6）d and （5.8±1.1）d,the indwelling time of urinary catheter was （9.3±1.3）d and （11.8±1.1）d,the VAS score was （2.3±1.3）d and （4.6±1.1）d, the IPSS score at the first,second and 4th week were （11.1±3.3） and （16.0±3.0）, （9.5±1.4） and （12.7±13.2）, （8.4±1.6） and （ll.3±2.7）,the score of life quality at the 4th week was （1.6±0.5） and （2.8±0.9）, respectively. All the above results had statistical difference between the observation group and the control group （P 〈 0.05）. Conclusion Standard bladder irrigation,rigorous monitoting of patients condition and maintenance of smooth flush of bladder were the important nursing basis to ensure the exertion of best effect of RTX irrigation.

关 键 词：良性前列腺增生 膀胱感觉神经阻滞剂 膀胱痉挛 手术 护理 

分 类 号：R699.8[医药卫生—泌尿科学] R737.14[医药卫生—外科学]