经尿道等离子双极汽化前列腺电切术后膀胱痉挛的护理干预研究

目的探讨护理干预对减少经尿道等离子双极汽化前列腺电切术(PKRP)后膀胱痉挛的效果。方法选取行PKRP的前列腺增生(BPH)患者160例,按照手术申请单提交顺序,随机分为对照组与干预组各80例,对照组患者给予常规护理;干预组患者在常规护理基础上采取调节导尿管气囊注水量、膀胱冲洗液温度,术后应用硬膜外镇痛泵及镇静药物等综合护理干预措施。比较两组患者手术时间、术后镇痛剂使用率及术后膀胱痉挛发生率,回顾性分析护理对策并进行改进。结果干预组患者手术时间、术后镇痛剂使用率均显著少于对照组,差异有统计学意义(P<0.01);血尿、膀胱痉挛、尿液反流等发生例数均明显少于对照组,住院医疗费用较对照组明显减少,护理满意度较对照组明显提高,差异均有统计学意义(P<0.05)。结论采取调节导尿管气囊注水量、膀胱冲洗液温度,术后应用硬膜外镇痛泵及镇静药物等综合护理干预措施,对减少前列腺电切术后膀胱痉挛的发生有满意的效果。

Study on nursing intervention on bladder spasm after transurethral plasma bipolar vaporization of prostate electrotomy

Objective To explore the effect of nursing intervention on reducing the occurrence of bladder spasm after transurethral plasma bipolar vaporization of prostate electrotomy（PKRP）. Methods 160 patients with PKRP were selected and divided into the control group and the intervention group with 80 cases in each group according to the order submitting in the surgery- application form. The control group was given with routine care. On the basis of routine nursing, the intervention group was given the comprehensive measures such as adjusting the catheter airbag injected water volume and bladder irrigation fluid temper- ature, postoperative epidural analgesia pump and the application of sedative drugs. The operative time, postoperative analgesic use rate and incidence rate of postoperative bladder spasm were compared between the two groups. The nursing strategy was retrospectively analyzed and conducted the improvement. Results The operative time, postoperative analgesic use in the intervention group were significantly less than those in the control group（P〈0.01 ）;the cases complicated with hematuria,bladder spasms and urine reflux,etc, were significantly less than those in the control group ;the cost of hospitalization was obviously decreased compared with the control group;the uursing satisfaction in the intervention group was significantly higher than that in the control group （P〈0.05）. Conclusion Adopting the comprehensive nursing intervention measures including adjusting catheter airbag injected water volume and bladder irrigation fluid temperature, postoperative epidural analgesia pump and the application of sedative drugs has the satisfactory effects for reducing the occurrence of bladder spasm after PKRP.