【摘要】：目的：探討膀胱沖洗液溫度對老年患者經(jīng)尿道前列腺電切術(shù)(TURP)術(shù)后膀胱痙攣和出血的影響，旨在為老年患者TURP術(shù)后的護(hù)理提供臨床依據(jù)。 方法：本研究采取隨機(jī)對照的臨床試驗(yàn)方法，選取石河子大學(xué)醫(yī)學(xué)院第一附屬醫(yī)院泌尿外科擇期在連續(xù)硬膜外麻醉下行經(jīng)尿道前列腺電切術(shù)的老年患者94例。按照隨機(jī)數(shù)字表將患者分為試驗(yàn)組(n=45)和對照組(=49),患者術(shù)后給予持續(xù)膀胱沖洗。試驗(yàn)組膀胱沖洗液的溫度為35℃～37℃，對照組膀胱沖洗液的溫度為25℃～29℃。記錄兩組患者術(shù)后發(fā)生膀胱痙攣的例數(shù)、每例發(fā)生膀胱痙攣的次數(shù)、膀胱痙攣癥狀的評分、血塊堵管的例數(shù)、術(shù)后持續(xù)膀胱沖洗的時間、沖洗液量。 結(jié)果：兩組患者TURP術(shù)后膀胱痙攣的發(fā)生率為36.2%，試驗(yàn)組術(shù)后膀胱痙攣的發(fā)生率為24.4%，對照組術(shù)后膀胱痙攣的發(fā)生率為46.9%，組間差異有統(tǒng)計(jì)學(xué)意義(χ2=5.141，P=0.023)；試驗(yàn)組術(shù)后膀胱痙攣的發(fā)作次數(shù)為1～2次，，對照組術(shù)后膀胱痙攣的發(fā)作次數(shù)為2～10次，組間差異有統(tǒng)計(jì)學(xué)意義(Z=-3.645，P=0.000)；兩組膀胱痙攣得分均為4～5分，組間差異無統(tǒng)計(jì)學(xué)意義(Z=-1.755，P=0.079)。試驗(yàn)組血塊堵管的發(fā)生率為8.9%，對照組血塊堵管的發(fā)生率為28.6%，組間差異有統(tǒng)計(jì)學(xué)意義(χ2=5.870，P=0.031)；試驗(yàn)組術(shù)后持續(xù)膀胱沖洗的時間為64～70.5h、沖洗量為24～52L,對照組術(shù)后持續(xù)膀胱沖洗的時間為68.5～92L、沖洗量為30～69L，組間差異均有統(tǒng)計(jì)學(xué)意義(Z=-2.902，P=0.004；Z=-1.965，P=0.049)。 結(jié)論：老年患者TURP術(shù)后膀胱痙攣的發(fā)生率為36.2%；老年患者TURP術(shù)后將沖洗液加溫至35℃～37℃能有效的降低膀胱痙攣的發(fā)生率，減少膀胱痙攣的發(fā)生次數(shù)，提高患者的舒適度；老年患者TURP術(shù)后將沖洗液加溫至35℃～37℃能減少術(shù)后出血量，促進(jìn)患者早日康復(fù)。
[Abstract]:Objective: to investigate the effect of bladder washing fluid temperature on bladder spasm and bleeding after transurethral resection of prostate (TURP) in elderly patients, in order to provide clinical basis for nursing care of elderly patients after TURP. Methods: a randomized controlled clinical trial was conducted in 94 elderly patients undergoing transurethral resection of the prostate under continuous epidural anesthesia in the first affiliated Hospital of Shihezi University Medical College. Patients were randomly divided into two groups: experimental group (n = 45) and control group (n = 49). The temperature of bladder flushing fluid was 35 鈩

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