1618例肺癌患者围术期无尿管留置后再置管的危险因素分析

目的 分析常规无尿管留置的肺癌患者术后再置尿管的原因及危险因素.方法 回顾性分析2013～2019年我院胸外科肺癌手术围术期常规无尿管留置的1 618例患者的临床资料,其中男791例、女827例,中位年龄58(27～85)岁.并分析无尿管留置失败再置管的危险因素.结果 纳入患者中尿管再置率为1.5％(24/1 618)...     

糖尿病下肢骨折患者的围术期护理

目的 探讨糖尿病骨折患者围术期护理特点。方法 对26例糖尿病骨折患者行手术治疗，术前做好健康评估、心理护理、饮食护理及血糖监测，术后行肢体护理、压疮预防、疼痛观察及血糖监测。结果 26例患者伤口拆线时间为14～18d，均为一期愈合。随访无1例发生护理并发症，肢体功能恢复满意。结论 充分的术前准备、有效的血糖监测是保证糖尿病骨折患者手术成功的关键。     

单侧髋膝关节置换患者围术期不留置尿管的可行性研究

目的探讨腰麻下行单侧髋膝关节置换术患者不留置尿管的可行性。方法分析147例行单侧髋膝关节置换术患者的临床资料。将患者分为尿管组69例和无尿管组78例,比较两组尿潴留发生率,并对无尿管组尿潴留影响因素进行分析。结果两组术后尿潴留发生率比较,差异无统计学意义(P0.05)。术后输液量是单侧髋膝关节置换术术后尿潴留的危险因素(P0.05)。结论单侧髋膝关节置换患者术前无需常规留置尿管,但应控制术后输液量,以减少术后尿潴留发生风险。     

留置尿管致漏尿的相关性分析及护理干预

目的:总结患者留置导尿管发生漏尿的原因及护理干预.方法:按无菌操作导尿术程序留置尿管,发生漏尿及时排除原因,并采取针对性护理措施.结果:护理干预后发生漏尿较干预前显著降低,差异有显著意义(P＜0.05).结论:使用气囊尿管留置导尿过程中,正确的护理干预可以有效地预防和纠正漏尿的发生.     

糖尿病下肢骨折患者的围术期护理

目的 探讨糖尿病骨折患者围术期护理特点.方法 对26例糖尿病骨折患者行手术治疗,术前做好健康评估、心理护理、饮食护理及血糖监测,术后行肢体护理、压疮预防、疼痛观察及血糖监测.结果 26例患者伤口拆线时间为14～18 d,均为一期愈合.随访无1例发生护理并发症,肢体功能恢复满意.结论 充分的术前准备、有效的血糖监测是保证糖尿病骨折患者手术成功的关键.     

骨科手术患者留置尿管的护理干预的对比分析

目的通过对手术留置导尿患者实施护理干预,从而缩短术后留置尿管的时间,减少拔管后尿潴留的发生,提高拔管成功率。方法将152例骨科住院需手术病人随机分为2组,实验组采取在围手术期充分宣教,术后拔管前采取膀胱充盈状态下,擦洗尿道口与自主排尿相结合的方式等护理干预。对照组按常规方式。观察2组拔管后尿潴留发生的几率及拔管成功率的指标。结果试验组拔管成功率明显高于对照组。结论围手术期采取充分的护理干预可提高拔管成功率。     

针对性护理对留置尿管患者预防尿路感染的影响分析

目的分析针对性护理对留置尿管患者尿路感染的影响。方法对58例留置尿管的住院患者实施针对性预防护理措施,观察留置尿管时间和其间尿路感染的发生率。结果本组患者导尿管留置时间(9.8±1.2)d,尿路感染发生率为5.2%(3/58)。结论对留置尿管患者尿路感染发生的危险因素进行科学评估,并实施针对性预防护理,可有效减少尿路感染的发生率,缩短尿管留置时间。     

留置尿管拔除后发生尿潴留的预防及护理

全身麻醉下行整形外科手术的患者要留置导尿管，但拔除后极易发生尿潴留，为预防拔除尿管后尿潴留的发生，笔者自2002年1月至2003年9月对68例患者在全麻下行整形手术留置导尿管，在拔除尿管前对患者采用38℃．40℃复合溶液100ml从尿管中注入的方法，均取得了满意的效果，现报道如下。     

妇科手术患者留置气囊尿管的护理体会

正留置导尿管是妇科术前准备的最基本的护理措施,不仅利于记尿量、密切观察患者的病情变化,也有利于排空膀胱充分暴露手术野,从而避免术中损伤临近器官。此外,可预防术后尿潴留、减轻手术切口的张力,促进切口的愈合[1]。2014-03—2016-03,我院对584例妇科手术患者留置气囊尿管,现将气囊尿管的护理体会总结如下。1资料与方法1.1一般资料本组584例患者,年龄17~68岁,平均年龄48     

剖宫产病人留置尿管的固定方法及护理

目的:探讨剖宫产病人留王尿管的固定方法及护理要点,方法:采用气囊导尿管导尿,用“U”双固定法固定尿管,评估病人的舒适度夏卫生改善状况.结果:通过尿管“U”双固定法的应用,会历护理更易操作、到住,病人更感舒适,活动方便.结论:尿管的“U”双固定法及合理的护理,降低了病人的泌尿系感染,值得在产科中应用推广.     

Bacterial biofilms in patients with indwelling urinary catheters

Bacteria have a basic survival strategy: to colonize surfaces and grow as biofilm communities embedded in a gel-like polysaccharide matrix. The catheterized urinary tract provides ideal conditions for the development of enormous biofilm populations. Many bacterial species colonize indwelling catheters as biofilms, inducing complications in patients' care. The most troublesome complications are the crystalline biofilms that can occlude the catheter lumen and trigger episodes of pyelonephritis and septicemia. The crystalline biofilms result from infection by urease-producing bacteria, particularly Proteus mirabilis. Urease raises the urinary pH and drives the formation of calcium phosphate and magnesium phosphate crystals in the biofilm. All types of catheter are vulnerable to encrustation by these biofilms, and clinical prevention strategies are clearly needed, as bacteria growing in the biofilm mode are resistant to antibiotics. Evidence indicates that treatment of symptomatic, catheter-associated urinary tract infection is more effective if biofilm-laden catheters are changed before antibiotic treatment is initiated. Infection with P. mirabilis exposes the many faults of currently available catheters, and plenty of scope exists for improvement in both their design and production; manufacturers should take up the challenge to improve patient outcomes.     

院外留置导尿管患者的家庭随访指导

目的探讨家庭留置导尿管患者的护理管理方法。方法将128例家庭留置导尿管患者按时间顺序分为对照组(62例)和干预组(66例),对照组实施常规护理指导;干预组在此基础上首先调查评估再进行家庭随访指导,包括心理护理,尿路感染、尿液引流不畅、患者不适感、尿道口渗尿及拔管困难的预防等指导。结果干预组患者留置导尿管并发症发生率显著低于对照组(P<0.05,P<0.01),照顾者知识掌握情况显著优于对照组(P<0.05,P<0.01)。结论实施家庭随访指导能明显降低留置导尿管患者并发症的发生,提高家庭留置导尿管患者照顾者的管理能力。     

Relationship between urease-producing bacteria, urinary pH and encrustation on indwelling urinary catheters

In 11 patients with long-term indwelling catheters the amount of catheter encrustation and urinary pH were measured and the urine regularly cultured over a prolonged period of time (median of 7 periods of 3 weeks). The mean urinary pH was related to the persistent presence of urease-producing micro-organisms (P. mirabilis) and urinary pH governed the precipitation of catheter encrustation. The critical pH appeared to be around 6.8. In patients with a mean urinary pH below this level the encrustation was minute (less than or equal to 2.9 mg phosphate). In patients with a mean urinary pH above 6.8 it was considerable but with a marked interindividual variation (35.5-138.7 mg phosphate). The composition of the encrustation was also strongly pH-related, with a much higher proportion present as magnesium ammonium phosphate in patients with a mean urinary pH above 6.8. The persistent presence of urease producers was not associated with a high pH or a more pronounced precipitation of phosphate in all patients. The amount of encrustation thus appears to depend not only on the presence of urease-producing micro-organisms but also on individual factors such as urinary composition.     

Polypoid cystitis unrelated to indwelling catheters

Since polypoid cystitis (PC) is generally caused by indwelling catheter use, in order to evaluate the patients with PC unrelated to a intravesical catheter, a retrospective analysis of the records of the Pathology Department of Turgut Özal Medical Center was performed and this revealed 8 patients. Mean age of the 2 female and 6 male patients was 48 years (28 to 70). None of the patients had bacterial growth in urine cultures. All cases were diagnosed incidentally by radiologic and cystoscopic examinations in the evaluation of different conditions, such as hematuria, ovarian abscess, bladder carcinoma, erectile dysfunction, neurogenic bladder, benign prostate hyperplasia and unexplained dysuria. At the beginning, all patients were diagnosed mistakenly as bladder carcinoma. The definitive diagnosis was made after histopathologic examinations of transurethrally resected specimens. Patients were followed for 6 months to 2 years after first diagnosis. No recurrence was established during follow-up. The final urologic examinations which were done currently, were normal.In conclusion, PC is a benign lesion and should be considered in the differential diagnosis of transitional cell carcinoma of the bladder.     

Experience with indwelling ureteral stent catheters.

A new indwelling ureteral stent to provide long-term ureteral drainage is described. This radiopaque stent is manufactured of non-reactive, non-collapsible tubing and is designed to resist downward expulsion and upward migration. Internal stent diversion offers advantages in managing patients whose ureters are obstructed by malignancy. 1) Endoscopic placement of the ureteral stent is associated with less morbidity and mortality than supravesical diversion. 2) Unilateral obstruction can be corrected at the time of diagnosis, thus ensuring that later supravesical diversion will not be necessary. 3) If time proves that the urinary diversion is no longer desirable in terms of quality of life, the stent can be removed.