清洁间歇性导尿联合穴位按摩治疗老年宫颈癌患者术后尿潴留的效果观察

目的观察清洁间歇性导尿联合穴位按摩治疗老年宫颈癌患者术后尿潴留的效果。方法选择2015年2月至2017年2月期间住院的90例老年宫颈癌术后尿潴留患者作为研究对象,根据数字表法随机分为清洁间歇性导尿组和联合组,每组各45例。清洁间歇性导尿组采用清洁间歇性导尿治疗,联合组采用清洁间歇性导尿联合穴位按摩治疗。两组治疗时间均为14 d。比较两组拔除尿管后疗效,留置尿管舒适度及术后7 d、14 d尿路感染率及残余尿量。结果联合组拔除尿管后的治愈率明显高于清洁间歇性导尿组(P0.05),而无效率明显低于清洁间歇性导尿组(P0.05);两组术后第14天、21天尿路感染率及术后第7天残余尿量比较差异无统计学意义(P0.05),但联合组术后第14天残余尿量明显少于清洁间歇性导尿组(P0.05);联合组留置尿管舒适度优于清洁间歇性导尿组(P0.05)。结论老年宫颈癌术后尿潴留患者采用清洁间歇性导尿联合穴位按摩治疗虽然没有明显减少尿路感染率,但拔除尿管后疗效、残余尿量及留置尿管舒适度均明显优于单一使用清洁间歇性导尿治疗,值得推广应用。     

清洁导尿的研究进展

清洁导尿是指在插入尿管前,不消毒尿道口,仅使用清水擦洗尿道口后,将尿管插入.这一方法最初主要应用于间歇性导尿,现在已逐渐推广到留置性导尿中,日益受到人们关注.目前,我国护理人员对清洁导尿的认识非常有限,本文旨在通过对清洁导尿相关研究进展的介绍,让临床护理工作者对清洁导尿的相关理论和方法有一个基本的了解,使清洁导尿法在日常护理工作中得到更广泛的应用,现报道如下.     

清洁导尿的研究进展

清洁导尿是指在插入尿管前，不消毒尿道口，仅使用清水擦洗尿道口后，将尿管插入。这一方法最初主要应用于间歇性导尿，现在已逐渐推广到留置性导尿中，日益受到人们关注。目前，我国护理人员对清洁导尿的认识非常有限，本文旨在通过对清洁导尿相关研究进展的介绍，     

间歇性导尿技术在宫颈癌根治术后早期拔除尿管病人中的应用

目的：观察间歇性导尿技术在宫颈癌根治术后早期拔除尿管病人中的应用。方法：将60例ⅠA1～ⅡA期行腹腔镜下子宫切除术及盆腔淋巴结清扫术病人按照随机数字表法分为试验组和对照组,每组各30例,手术后7天拔出导尿管后测量膀胱残余尿,当残余尿大于100ml时,试验组采用间歇性导尿技术,对照组按照宫颈癌护理常规给予重新留置尿管;比较两组病人泌尿系统感染发生率、住院期间舒适度评价、下床活动时间、自主排尿恢复时间、再次留置导尿的发生率、住院天数。结果：试验组病人泌尿系统感染发生率、住院期间舒适度评定、住院期间每日下床活动时间、自主排尿恢复时间、住院天数均优于对照组（P＜0.05）;两组病人再次留置导尿的发生率比较无统计学差异（P＞0.05）。结论：宫颈癌根治术后早期拔除尿管采用间歇性导尿技术可以促进膀胱功能恢复,降低泌尿系统发生感染的概率,方便病人活动,缩短住院时间,加速病人康复。     

神经源性膀胱患者尿路康复护理进展

文章对国内外神经源性膀胱患者尿路康复护理进行了综述,为临床工作者提供依据.阐明了康复护理和膀胱功能训练的方法及措施,主要包括持续引流和间歇性开放留置尿管、膀胱电刺激、间歇性导尿的护理要点.     

早期夹管放尿与自控排尿同步训练法对拔管后排尿成功率的影响

神经内科病人常存在中枢神经损伤导致尿潴留、尿失禁等排尿异常,经常需要为病人留置导尿,且留置时间较长.按照教科书要求,在拔除尿管前,需要采取定时放尿的方法,即在拔管前间歇性夹闭尿管,使膀胱定时充盈排空,以训练膀胱反射功能[1].但是拔管后还是经常出现尿潴留或尿失禁的情况,一部分病人必须再次留置导尿,这不利于病人康复,甚至导致泌尿系感染.为此,笔者采用留置尿管后即采取夹闭尿管放尿与自控排尿同步训练与常规膀胱功能训练方法相比较,以寻求拔尿管后减少尿潴留的最佳方法.现报告如下.     

间歇性导尿联合综合护理干预在腰椎术后尿潴留患者中的应用

目的探讨间歇性导尿联合综合护理干预对腰椎术后患者拔除尿管后解除尿潴留的临床效果。方法收集2016年2月~2017年2月在本科行腰椎手术术后拔除尿管后尿潴留的患者76例,用信封法随机分为观察组38例和对照组38例,观察组患者采取间歇性导尿联合综合护理措施,对照组患者采取留置导尿的措施解除患者尿潴留,分别统计2组患者尿路感染发生率、平均导尿费用、平均导尿护理时间和患者的舒适度。结果观察组患者尿路感染发生率、平均导尿费用、平均导尿护理时间和患者的舒适度观察组均优于对照组,P均0.05。结论对腰椎术后尿潴留的患者采取间歇性导尿联合综合护理干预的措施是行之有效的办法,有利于患者尽早建立自主排尿,降低了泌尿系统的感染率,减少了患者因导尿产生的住院费用及医护人员导尿护理时间,提高了患者的舒适度。     

便携式膀胱扫描仪与尿流动力学联合检查在患者间歇导尿中的应用分析

目的 探讨便携式膀胱扫描仪结合尿流动力学检查在患者间歇导尿中的应用效果.方法 选取四川大学华西医院拟行间歇导尿患者60例,按随机数字表法分为对照组和试验组各30例.对照组在尿流动力学检查指导下进行饮水计划和间歇性导尿,试验组在对照组基础上应用便携式膀胱扫描仪监测患者尿量并开展间歇性导尿,观察两组治疗前后膀胱容量及残余尿...     

间歇性导尿在神经源性膀胱中的应用进展

综述了间歇性导尿在神经源性膀胱中的应用进展。包括间歇性导尿术的分类、时机、指征、间歇时间、操作流程、宣教管理、导尿管的选择、与留置尿管相比的优点、并发症及注意事项,旨在尽可能地帮助患者减少神经源性膀胱引起的泌尿系统并发症,提高患者生存质量。     

早期拔除尿管与清洁间歇性导尿术相结合在腹腔镜下广泛性子宫切除术后的应用

目的探讨清洁间歇性导尿术在腹腔镜下广泛性子宫切除术后膀胱功能恢复中的应用价值。方法回顾性分析我院2015年1月至2017年12月因宫颈癌IB1或IIA1行腹腔镜下广泛性子宫切除术及盆腔淋巴结切除术的168例患者资料。其中64例患者术后3~5日拔除导尿管开始进行清洁间歇性导尿为研究组,104例患者术后长期留置尿管为对照组。比较两组间恢复正常排尿的时间与尿路感染比率,评价清洁间歇性导尿术在膀胱功能恢复中的临床价值。结果研究组患者恢复自主排尿时间明显短于对照组,尿路感染发生率也明显低于对照组,差异有统计学意义(P0.01)。结论对腹腔镜下广泛性子宫切除术患者术后早期拔除尿管,采用清洁间歇性导尿策略有助于促进术后膀胱功能的恢复、降低尿路感染的发生。     

截瘫患者自我间歇导尿及康复护理

目的：观察截瘫患者自我间歇导尿的临床效果。方法：指导15例截瘫患者掌握自我间歇导尿的方法，并定期做尿常规和洗手前后细菌培养等临床观察。结果：15例患者停止留置尿管，与治疗前留置尿管时的感染率比较有显著改善，患者洗手前后细菌培养均在正常范围。结论：截瘫患者采用自我间歇导尿法来解决不能自解小便的问题比留置尿管更有利于患者的康复。     

广东地区神经源性膀胱康复护理管理及间歇导尿临床应用现况调查

目的 调查广东地区护士对神经源性膀胱和间歇导尿相关知识的认知及临床应用情况。方法 2020年12月至2021年1月,采用自行设计问卷量表,对广东地区的241名护士进行调查。结果 护士对神经源性膀胱和间歇导尿相关护理知识知晓自我评价得分较低。护士对神经源性膀胱的并发症及风险管理答题正确率较低。临床上虽然排尿障碍患者较多,但67.2%的人回答仍采用留置尿管,仅24.1%使用间歇导尿。仅9.9%护士认为医生对排尿障碍患者采取积极的措施。大部分护士愿意参加神经源性膀胱及间歇导尿相关培训及护理联盟,也愿意对出院后神经源性膀胱患者进行康复护理管理。结论 护士对神经源性膀胱和间歇导尿相关指南的知识认知不足,未将知识应用于临床,需要有针对性地采取进一步措施提高护士的认知,提升神经源性膀胱的规范管理。     

脊柱手术患者拔除尿管后尿潴留应用开塞露灌肠联合间歇导尿的效果观察

目的 探讨脊柱手术拔除尿管后发生尿潴留的患者应用开塞露小量不保留灌肠联合间歇导尿的效果.方法 将脊柱手术拔除尿管后出现尿潴留的52例患者随机分为对照组24例和观察组28例.对照组运用常规尿潴留的处理流程:采用诱导排尿术,无效患者采用开塞露塞肛诱导排尿,以上措施无效患者,予重新留置尿管;观察组在运用诱导排尿术无效后,加用开塞露小量不保留灌肠联合间歇导尿处理,以上措施无效患者,予重新留置尿管.分别统计两组患者经诱导排尿术后自主排尿的例数,及拔除尿管后12 h实施各组尿潴留处理流程后自主排尿的例数.结果 两组尿潴留患者经诱导排尿术后自主排尿情况比较,差异无统计学意义(P＞0.05);拔除尿管后12 h实施各组尿潴留处理流程后自主排尿情况比较,观察组明显优于对照组,差异有统计学意义(P<0.01).结论 脊柱手术拔除尿管后尿潴留患者应用开塞露小量不保留灌肠联合间歇导尿,有利于患者尽早恢复自主排尿.     

Studying the quality of life and life satisfaction among persons with spinal cord injury undergoing urinary management.

The purpose of this survey was to investigate quality of life and life satisfaction among persons with spinal cord injury (SCI) who require various types of urinary management. A sample of 230 persons with SCI completed the Quality of Life Index (QLI), the Satisfaction With Life Scale (SWLS), and a demographic data form. Findings of this study indicated that there was no significant difference in QLI and SWLS with regard to the type of urinary management used (reflex voiding, indwelling catheter, suprapubic catheter, intermittent catheterization, external catheter or a combination of intermittent catheterization and external catheter). There also was no significant difference in QLI and SWLS with regard to the level of SCI or the incidence of hospitalizations for urinary infections. There were significantly higher QLI and SWLS scores for those with greater abilities to work, attend school, and participate in activities. There also was a significantly higher QLI for those without skin problems associated with urinary dysfunction.     

Review of intermittent catheterization and current best practices

Intermittent catheterization is the insertion and removal of a catheter several times a day to empty the bladder. This type of catheterization Is used to drain urine from a bladder that is not emptying adequately or from a surgically created channel that connects the bladder with the abdominal surface (such as Mitrofanoff continent urinary diversion). Intermittent catheterization is widely advocated as an effective bladder management strategy for patients with incomplete bladder emptying due to idiopathic or neurogenic bladder dysfunction. Urologic nurses are at the forefront of educating and teaching patients how to self-catheterize. Catheterizations performed in institutions, such as acute and rehabilitation hospitals and nursing homes, are done aseptically. Historically, however, intermittent catheterization has been performed by the patient in the home environment using a clean technique involving the re-use of catheters. New guidelines released in the past three years have recommended changes to the practice of re-using catheters. Currently, nurses use their clinical judgment to determine which technique and type of catheter to use, in conjunction with patient preference. Differential costs and insurance coverage of catheters/echniques may also influence decision making. The authors provide an overview of the indications, use, and complications associated with intermittent catheterization, present current guidelines on self-catheterization and treatment of catheter-associated complications, detail types of catheters, and review clinical practice of intermittent catheterization.     

间歇导尿与留置导尿治疗尿潴留的系统评价

[目的]系统评价间歇导尿与留置导尿治疗尿潴留的有效性和安全性。[方法]采用Cochrane系统评价方法,计算机检索PubMed,EMBASE,Co-chrane图书馆,CBM,CNKI,VIP等数据库,手工检索相关领域的杂志,并用Google Scholar和Medical Martix等搜索引擎在互联网上查找相关文献。收集有关间歇导尿与留置导尿比较治疗尿潴留的随机或半随机对照试验,按照Cochrane系统评价员手册4.2.6版推荐的质量评价标准纳入研究质量,并对同质研究采用RevMan5.1进行Meta分析。[结果]共纳入8个随机对照试验,包括797例病人。2个研究采用随机数字表进行分组,2个研究描述了分配隐藏,2个研究描述了盲法。Meta分析结果显示:间歇导尿组的病人尿路感染人数少于留置导尿组[OR=0.56,95%CI(0.37,0.87)],差异有统计学意义。两组在导尿术一段时间后排尿正常人数[OR=1.48,95%CI(0.74,2.95)]和不适感人数[OR=0.59,95%CI(0.21,1.68)]方面的差异无统计学意义。[结论]现有证据表明,间歇导尿术治疗尿潴留在降低尿路感染方面优于留置导尿,而在导尿术一段时间后排尿正常人数和不适感人数等方面没有证据证明其有优势。     

Urinary catheters: selection,management and prevention of infection

Urinary catheterization is a common procedure for both hospital and community patients. Nurses make many of the decisions in regard to both catheter selection and subsequent catheter care. These decisions, for example, in the type of catheterization (intermittent, indwelling, urethral or suprapubic) should be made on an informed basis. Choosing the optimum catheter material and size can benefit catheter care. Encrustation can be a problem for some catheterized patients and nurses are often involved in trying to prevent or treat it. This and other aspects of catheter management including infection control, constipation and meatal hygiene are discussed.     

Flocath quick: a new hydrophilic-coated catheter for intermittent use

The following article looks at the new Flocath quick intermittent catheter, which as been developed with the aim of improving the quality of lives of clients and carers who undertake intermittent catheterization. Teleflex Medical (formerly Rusch UK) provides an extensive range of intermittent catheters in both male and female lengths, as well as a range of indwelling catheters widely used throughout the community, hospitals and private nursing facilities.     

No-Touch Catheterization and Infection Rates in a Select Spinal Cord Injured Population

A clinical trial comparing two intermittent catheterization techniques used with spinal cord injured patients at Parkwood Hospital, a long-term care facility in London, ON, Canada, was conducted to evaluate the techniques' effect on urinary tract infections (UTIs). Charts were reviewed retrospectively for 92 patients with traumatic spinal cord injury who were on intermittent catheterization between January 1985 and December 1988. Nearly 80% of these patients had more than one UTI per admission. A convenience sample of 18 patients with traumatic spinal cord injury participated in a prospective study using a no-touch method of catheterization for 7 months. Preliminary findings at the completion of the study revealed that 44.4% of this experimental group had more than one UTI per admission—a 44.5% reduction. The no-touch method using the O'Neil Sterile Field? urinary catheter was successful in reducing the total number of infections and duration of infection for the experimental group. A nurse satisfaction questionnaire revealed that nursing staff preferred this method of intermittent catheterization to the traditional method.