改良式拔尿管法对尿管拔除时排尿的效果观察  

Effects of improved catheter extubation method on urination

作　　者：苏晚英 吴卉[1] 秦梅兰[2] 余小卫[1] 林艾 杨敏珏 Su Wanying;Wu Hui;Qin Meilan;Yu Xiaowei;Lin Ai;Yang Minjue(Joint Surgery and Sports Medicine Department,Hunan Provincial People′s Hospital,Changsha 410005;Department of Traumatic Orthopedics,Hunan Provincial People′s Hospital,Changsha 410005,China)

机构地区：[1]湖南省人民医院关节与运动医学科,长沙410005 [2]湖南省人民医院创伤骨科,长沙410005

出　　处：《中国实用护理杂志》2020年第34期2691-2694,共4页Chinese Journal of Practical Nursing

摘　　要：目的探讨改良式拔尿管法与传统拔尿管法对尿管拔除时的排尿疼痛、排尿情况、首次排尿时间及首次排尿量的影响。方法选择术后留置导尿管的144例患者作为研究对象,采用计算机数字随机分组法分为对照组和观察组各72例。对照组在术后返回病房时开始夹闭导尿管训练膀胱功能,采用传统方法拔除导尿管;观察组在拔管前根据尿袋内尿液250 ml以上判断患者有排尿反射,用注射器抽尽气囊内的0.9%氯化钠后再往回注0.5 ml,嘱患者自行排尿,将尿管随尿液排出体外。分析比较2组患者拔管时的排尿疼痛、排尿情况、首次排尿时间及首次排尿量。结果观察组尿管拔除时的排尿疼痛、首次排尿时间、自主排尿的发生率分别为(1.47±1.48)分、(20.44±12.98)min、95.8%(69/72),对照组分别为(3.11±1.98)分、(28.03±27.00)min、83.3%(60/72),2组比较差异有统计学意义(t值为-5.644、-2.148,χ2值为6.628,均P<0.05);观察组与对照组的首次排尿量分别为(258.6±41.57)、(248.14±48.82)ml,2组比较差异无统计学意义(t值为1.377,P>0.05)。结论改良式拔尿管法,可显著降低尿管拔除时的排尿疼痛,缩短患者首次排尿时间,提高自行排尿的成功率,值得临床推广应用。Objective To compare the effects between improved catheter extubation method and the traditional one on urination pain,urinary retention,first urination time and first urination volume,and to evaluate the advantage of the improved method.Methods 144 patients with indwelling catheters after operation in our department were randomly divided into observation group and control group,with 72 cases in each group.The control group returned to the ward after surgery and began to clamp the urinary tube to train the bladder function,the catheter was removed by traditional method.Observation group:urination reflex was evaluated before extubation,according to more than 250 ml urine in the urine bag.Pumping the saline of the gas bag and injecting back 0.5ml to keep the wall of the bag smooth,eventually the catheter was excreted when urinating.Urethral pain,urinary retention,first micturition time and first micturition volume of two groups were analyzed.Results Urethral pain,urinary retention,first micturition time in observation group and control group were 1.47±1.48,(20.44±12.98)min,95.8%(69/72)and 3.11±1.98,(28.03±27.00)min,83.3%(60/72),respectively,and the difference between the two groups was statistically significant(t value was-5.644,-2.148,χ2 value was 6.628,all P<0.05).The first micturition volume in observation group and control group were(258.6±41.57)ml and(248.14±48.82)ml,respectively,and there was no significant difference between the two groups(t value was 1.377,P>0.05).Conclusion The improved catheter extubation method could significantly reduce the urethral pain,shorten the time of the first urination,and improve the success rate of self-urination,which of clinical promotion.

关 键 词：导尿管 排尿 疼痛 排尿反射 拔管 

分 类 号：R472[医药卫生—护理学]