耻骨上经膀胱前列腺摘除术后发生膀胱痉挛的原因分析及护理

目的分析耻骨上经膀胱前列腺摘除术后发生膀胱痉挛的原因及总结护理要点。方法2005年2月-2007年10月对114例前列腺增生症患者实施耻骨上经膀胱前列腺摘除术，观察术后发生膀胱痉挛的情况，并分析原因，给予针对性的护理对策。结果52例发生膀胱痉挛（占45．6％），其中由膀胱自身因素或神经系统因素所致26例（占50．O％），血块梗阻引流管所致19例（占36．5％），冷刺激所致4例（占7．7％），气囊过大压迫所致2例（占3．8％），手术中损伤膀胱黏膜所致1例（占1．9％）。结论对患者做好术前后心理护理，减轻焦虑因素引起的膀胱痉挛；术后保持膀胱引流通畅，做好管道引流护理，并配合中医技术护理，可预防、减轻、缓解和控制膀胱痉挛发作，从而达到减轻患者痛苦的目的。

Causes and nursing of bladder spasm after the suprapubic transvesical prostatectomy

Objective To analyze the causes for urinary bladder spasm after the suprapubic transvesical prostatectomy, and to summarize the key points for nursing. Methods The urinary bladder spasm situations in 114 patients with hyperplasia of prostate after the suprapubic transvesical prostatectomy from February 2005 to October 2007 were observed, the causes were analyzed and the pertinent nursing strategies were provided. Results Urinary bladder spasm occurred in 52 cases （45.6%） Among them, 26 cases （50. 0% ） caused by urinary bladder or nerve system factors, 19 cases （36. 5% ） caused by blood-clot obstructing the drainage tube, 4 cases （7.7%） caused by coldness stimulus, 2 cases （3.8%） caused by the pressure by overlarge aerocyst, and 1 case （1.9%） caused by urinary bladder mucosa biopsy injury in the operation. Conclusion Through psychological nursing to patients before and after the operation to lessen the anxiety, postoperative urinary bladder drainage, combined with the nursing techniques of Traditional Chinese Medicine, urinary bladder spasm can be prevented, lessened and controlled, and patients＇ the pain can be relieved.