改良更换集尿袋操作方法在尿道狭窄留置导尿管患者中的应用

目的探讨改良更换集尿袋操作方法在尿道狭窄留置导尿管患者中的应用。方法将2009年3月至2010年12月住院的复杂性尿道狭窄留置导尿管患者160例按随机数字表法随机分成两组，每组各80例。观察组应用改良法更换集尿袋，对照组实施传统法更换集尿袋。比较两组留置导尿管不良反应发生率，患者对留置导尿管注意事项的认知程度，包括膀胱功能训练正确夹管方法，患者尿培养结果。结果观察组留置导尿管拔管困难者0例，明显少于对照组的4例，差异有统计学意义（x^2=4．103，P〈0．05）；观察组尿培养阳性率7．50％，明显低于对照组的21．25％，差异有统计学意义（x^2=6．144，P〈0．05）；观察组对留置导尿管注意事项的认知程度明显优于对照组（P〈0．05）。结论复杂性尿道狭窄留置导尿管患者应用改良法更换集尿袋，可以减少留置尿管不良反应发生，减少患者痛苦，使更换集尿袋操作方法更趋于合理性。

Application of modified method in replacing urine-collecting bags among urethral stricture patients with indwelling catheter

Objective To investigate the effect of modified method of replacing urine-collecting bags in urethral stricture patients with indwelling catheter. Methods One hundred and sixty patients were randomly assigned to experiment group and control group （80 patients in each group）. Patients in experiment group were replaced urine-collecting bags by improved method. In control group, traditional method was used. The incidence of side-effect, awareness on indwelling catheter cautions, earlier recovery exercise of bladder function by correct pipe-griping method as well as the urine culture result were evaluated. Results None of patients in experiment group showed difficulty in decannulation, and there was statistical difference among two groups （0 vs 4,X^2 = 4. 103,P 〈 0.05）. The positive rate of urine culture in experiment group was 7.50% and it was significantly lower than that in control group （21.25%） , and there was statistical difference among two groups （X^2 = 6. 144 ,P 〈 0.05 ）. Awareness on indwelling catheter cautions in experiment group was superior to control group （ P 〈 0.05 ）. Conclusions For patients indwelling catheter with complex urethral stricture, the application of improved method in replacing urine-collecting bags can reduce the incidence of side effects in indwelling catheter and alleviate patient＇ s discomfort. It makes the method of replacing urine-collecting bags more reasonable, and improves the quality of medical care and degree of patients＇ satisfaction.