行腹腔镜下膀胱根治性切除术患者术后发生肠梗阻的危险因素及护理干预措施研究  

Study of Risk Factors for Postoperative Development of Bowel Obstruction in Patients Undergoing Laparoscopic Radical Cystectomy and Nursing Interventions

作　　者：卢少芬 吴燕萍 Lu Shaofen;Wu Yanping(Department of Urology,The First Affiliated Hospital of the Fujian Medical University,Fuzhou,Fujian,350004,China)

机构地区：[1]福建医科大学附属第一医院泌尿外科,福建福州350004

出　　处：《黑龙江医学》2024年第8期999-1002,共4页Heilongjiang Medical Journal

摘　　要：目的:探讨行腹腔镜下膀胱根治性切除术(LRC)患者术后发生肠梗阻的危险因素及护理干预措施,为临床护理提供依据。方法:选取2020年5月—2022年5月福建医科大学附属第一医院收治的70例行LRC患者作为研究对象,将其中术后发生肠梗阻的19例患者分为观察组,术后未发生肠梗阻的51例患者分为对照组。采用单因素分析、多因素logistic回归分析两组患者LRC术后发生肠梗阻的危险因素,根据危险因素总结制定护理干预措施。结果:LRC术后发生肠梗阻的单因素分析结果显示,两组患者的年龄、身体质量指数(BMI)、术后24 h盆腔引流量、术后盆腔引流管留置时间、术后平均每日活动量、住院时间比较,差异有统计学意义(t=2.681、5.630、14.404、6.965、8.979、9.892,P<0.05)。多因素logistic回归分析结果显示,年龄、BMI、术后24 h盆腔引流量、术后盆腔引流管留置时间、术后平均每日活动量是LRC术后发生肠梗阻的独立危险因素,差异有统计学意义(OR=0.967、0.419、0.918、0.793、0.607,P<0.05)。结论:高龄、肥胖、术后活动量少易导致LRC患者术后发生肠梗阻。因此,临床需重视其危险因素,术前需筛选出高危患者,做好预防性护理干预,从而减少术后肠梗阻的发生。Objective:To investigate the risk factors and nursing interventions for postoperative bowel obstruction in patients undergoing laparoscopic radical cystectomy(LRC)and to provide a basis for clinical care.Methods:70 cases of postoperative LRC patients admitted to the hospital from May 2020 to May 2022 were selected as the study subjects,among which 19 patients who developed intestinal obstruction after surgery were divided into the observation group,and 51 patients who did not develop intestinal obstruction after surgery were divided into the control group.The risk factors for intestinal obstruction after LRC in both groups were analyzed using univariate analysis and multifactorial logistic regression,and nursing interventions were developed based on the summary of risk factors.Results:The results of the univariate analysis of the occurrence of intestinal obstruction after LRC showed that there were statistically significant differences between the two groups in terms of age,body mass index(BMI),pelvic drainage at 24 h after surgery,duration of retention of pelvic drainage tubes after surgery,average daily activity after surgery,and length of hospitalization(t=2.681,5.630,14.404,6.965,8.979,9.892;P<0.05).The results of multifactorial logistic regression analysis showed that age,BMI,24 h postoperative pelvic drainage,postoperative pelvic drain retention time,and average postoperative daily activity were independent risk factors for the development of intestinal obstruction after LRC,and the differences were statistically significant(OR=0.967,0.419,0.918,0.793,0.607;P<0.05).Conclusion:Advanced age,obesity,and low postoperative activity are likely to lead to intestinal obstruction after LRC.Therefore,clinical attention should be paid to its risk factors,high-risk patients should be screened out before surgery,and preventive nursing interventions should be made to reduce the occurrence of postoperative intestinal obstruction.

关 键 词：腹腔镜下膀胱根治性切除术 肠梗阻 危险因素 护理干预 

分 类 号：R473.6[医药卫生—护理学]