改良式拔尿管法对老年人拔管后排尿的影响

目的评估改良式拔尿管方法与传统拔管方法对老年人拔管后排尿的影响。方法将84例留置尿管的老年患者随机分为两组，实验组采用拔尿管前先夹闭尿管，在膀胱充盈时将灭菌后的开塞露注入膀胱，抽出尿管气囊内液体后再回注0．5ml生理盐水，让尿管随尿液自然排出的方法；对照组采用传统拔管方法拔除尿管，即在膀胱充盈时，抽出气囊内全部液体，拔除尿管。观察比较两组患者拔管后尿潴留及尿路刺激症状的发生情况。结果实验组患者拔除尿管后发生尿潴留及尿路刺激征的比率均显著低于对照组（P〈0．05）。结论改良式拔尿管法，可显著降低老年患者拔尿管后尿潴留、尿道损伤的发生率，减轻病人的痛苦，值得在临床推广。

Effects of improved catheter extubation method on urination of gerontal patient

Objective＇ To compare the effects between improved catheter extubation method and the traditional one on urination of gerontal patients, and to evaluate the advantage of the improved method. Method 84 gerontal pa- tients witl~ indwelling catheter were randomly divided into the control group and the experimental group. The pa- tients in control group accepted the traditional catheter extubation method, and the catheter was removed immediate- ly after extracted the liqid in balloon entirely. The improved catheter extubation method was used in the experimen- tal group. We injected the sterilized glycerol enema into the engorged bladder, then extracted the liqid in balloon en- tirely, and followed by infusing 0. 5 ml normal saline back to the balloon, and discharged the catheter along with uri- nating naturally in the end. The incidences of uroschesis and urinary irritation symptoms in two groups were com- pared. Result The incidences of uroschesis and urinary irritation symptoms in the experimental group were signifi- cantly lower than that of the control group（P~0. 05）. Conclusion The improved catheter extubation method could significantly reduce the incidences of urinary retention and urinary irritation symptoms, and alleviate the suffering of gerontal patient with indwelling catheter, so it is worthy to be popularized in the clinical nursing work.