间歇夹管结合提肛运动对妇科肿瘤术后患者拔除导尿管后排尿功能的影响  

Effect of intermittent pinch valve combined with anal levator movement on urination function after removal of catheter in patients with gynecological tumor

作　　者：陈琳 周利华[2] CHEN Lin;ZHOU Li-hua(Department of Gynecologic Tumor,Suzhou Municipal Hospital,Suzhou,Anhui 234000,China;不详)

机构地区：[1]宿州市立医院妇科病区,安徽宿州234000 [2]安徽医科大学护理学院,安徽合肥230032

出　　处：《中华全科医学》2020年第7期1245-1247,共3页Chinese Journal of General Practice

基　　金：安徽省高校自然科学研究项目(KJ2017A828)。

摘　　要：目的早期妇科肿瘤患者术中需要留置导尿,以保证术中和术后尿液引流的通畅。但患者术后常因各种原因导致排尿困难甚至尿潴留。本文主要探讨间歇性夹管结合提肛运动对妇科肿瘤患者拔除尿管后排尿功能的影响。方法选择2018年1月—2019年6月在宿州市立医院接诊妇科肿瘤手术治疗的患者90例,将患者按照随机数字表法分为试验组(45例)和对照组(45例)。对照组按照留置导尿的护理常规进行护理,试验组在常规护理的基础上采用间歇夹管结合提肛运动。采用秩和检验对2组患者拔管后首次排尿等待时间进行比较;采用χ^2检验对患者尿路刺激征以及排尿情况进行比较。结果对照组患者拔管后首次排尿时间为[105.0(35.2,210.4)]min,试验组为[30.0(10.5,65.7)]min,2组差异有统计学意义(U=506.000,P<0.01)。试验组尿路刺激征3例(6.7%),对照组为12例(26.67%),2组比较差异有统计学意义(χ^2=6.480,P<0.05)。试验组患者术后自主排尿43例(95.56%),需诱导排尿2例(4.44%),无患者需再次导尿;对照组术后自主排尿34例(75.56%),需诱导排尿7例(15.55%),4例(8.89%)需再次导尿,2组比较差异有统计学意义(χ^2=7.830,P<0.05)。结论间歇夹管结合提肛运动,在膀胱充盈或患者主诉尿意明显时拔除尿管,能明显减少首次排尿等待时间,促进患者尽早恢复自主排尿,降低再次导尿几率。Objective Patients with early stage gynecological tumors need indwelling catheterization during operation to ensure smooth urinary drainage during and after surgery.However,difficulty urinating or even urinary retention often oc-cur due to various reasons after surgery.This study aims to explore the effect of intermittent pinch valve combined with a-nal levator movement on urinary function after urinary catheter removal in gynecologic tumor patients.Methods Ninety patients with gynecologic tumors were enrolled from January 2018 to June 2019 in this study.Patients were randomly di-vided into experimental group(45 cases)and control group(45 cases)according to the random number table method.Patients in control group were nursed according to the nursing routine of indwelling catheterization,and that in experimen-tal group were nursed with intermittent pinch tube combined with anal movement on the basis of routine nursing,and the catheter was removed when the bladder was full or the patient complained of obvious urinary intention.Rank sum test was used to compare the waiting time for the first urination after extubation.Chi-square test was used to compare the distribu-tion of urinary tract irritation and urination.Results The first urination time in control group was[105.0(35.2,210.4)]min after extubation,and the experimental group was[30.0(10.5,65.7)]min,the difference was statistically significant(U=506.000;P<0.01).Totally,3(6.7%)patients in experimental group had urinary tract irritation signs,and 12(26.67%)in the control group had urinary tract irritation signs.The chi-square value was 6.480,and the difference was statistically significant(P<0.05).Totally,43(95.56%)patients in experimental group vomited spon-taneously after surgery,2(4.44%)patients needed to induce urination,and no patients needed re-catheterization.To-tally,34(75.56%)patients in the control group spontaneously urinate after surgery,and 7(15.55%)patients needed induce urination,and 4(8.89%)needed to urinate again.The chi-square value was 7.830,and

关 键 词：生殖器肿瘤 女性 排尿功能 留置导尿术 护理干预 

分 类 号：R473.71[医药卫生—护理学] R737.3[医药卫生—临床医学]