本文選題：膀胱功能訓(xùn)練 + 盆底重建術(shù)��； 參考：《鄭州大學(xué)》2017年碩士論文

【摘要】：目的:比較常規(guī)護(hù)理及系統(tǒng)性膀胱功能鍛煉下兩組患者尿管重置率、尿潴留發(fā)生率及拔管后殘余尿量測(cè)定情況,探討系統(tǒng)性膀胱功能煅練對(duì)預(yù)防盆底重建術(shù)后尿潴留的效果。通過(guò)實(shí)施護(hù)理干預(yù),減低術(shù)后尿潴留的發(fā)生率,降低尿管重置率,預(yù)防泌尿系統(tǒng)感染,從而減輕患者的病痛。方法:本研究為類試驗(yàn)性研究,采取兩種不同干預(yù)措施預(yù)防盆底重建術(shù)后尿潴留。2016年5月至2016年12月期間,根據(jù)整群隨機(jī)原則將某醫(yī)院兩個(gè)婦科病區(qū)的符合入選標(biāo)準(zhǔn)的患者分配入試驗(yàn)組或?qū)φ战M,兩組患者各55例,對(duì)照組行常規(guī)護(hù)理,試驗(yàn)組在行常規(guī)護(hù)理的基礎(chǔ)上實(shí)施系統(tǒng)性膀胱功能鍛煉,干預(yù)時(shí)間從術(shù)前3天直至拔除尿管順利排尿,責(zé)任護(hù)士收集記錄兩組患者干預(yù)后尿管重置率、尿潴留發(fā)生率、尿管留置時(shí)間、測(cè)殘余尿量情況、尿常規(guī)結(jié)果、體溫、膀胱刺激癥狀的發(fā)生率及尿路感染例數(shù)等指標(biāo)。所有資料均采用SPSS 21.0統(tǒng)計(jì)軟件處理。兩組各觀測(cè)指標(biāo)中計(jì)量資料采用t檢驗(yàn)進(jìn)行比較,計(jì)數(shù)資料比較采用χ2檢驗(yàn)及fisher’s確切概率法,檢驗(yàn)水準(zhǔn)α=0.05。結(jié)果:1.試驗(yàn)組共有12例患者重置尿管,尿管重置率為21.82%,對(duì)照組有23例患者,重置率41.82%。經(jīng)檢驗(yàn),χ2=7.880,P0.05,兩組患者尿管重置率差異有統(tǒng)計(jì)學(xué)意義。2.試驗(yàn)組共有13例患者被確認(rèn)存在尿潴留,發(fā)生率為23.64%,對(duì)照組發(fā)生率為38.18%。經(jīng)檢驗(yàn),χ2=6.714,P0.05,兩組患者尿潴留發(fā)生率差異有統(tǒng)計(jì)學(xué)意義。3.試驗(yàn)組尿管留置時(shí)間為(55.14+19.53),對(duì)照組為(64.58+21.60),t=2.334,P0.05,差異有統(tǒng)計(jì)學(xué)意義;經(jīng)檢測(cè),尿殘余量為(20.45+27.00),對(duì)照組為(30.55+25.44),t=2.017,P0.05,差異有統(tǒng)計(jì)學(xué)意義,提示該方法可有效的減少尿液的潴留。4.對(duì)照組膀胱刺激征發(fā)生例數(shù)(19例)高于試驗(yàn)組(13例),其中對(duì)照組患者反映存在膀胱刺激征者占34.55%,試驗(yàn)組報(bào)告有膀胱刺激征的患者為23.64%。但是分析發(fā)現(xiàn)兩組之間差異無(wú)統(tǒng)計(jì)學(xué)意義。5.試驗(yàn)組尿路感染發(fā)生率(5.45%)低于對(duì)照組(17.02%),主要判斷方法為尿沉渣鏡檢結(jié)果中白細(xì)胞的數(shù)量,但兩組之間差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論:系統(tǒng)性膀胱功能訓(xùn)練對(duì)預(yù)防盆底重建術(shù)后尿潴留的發(fā)生具有較好效果,盡管在預(yù)防尿路感染和減少膀胱刺激征方面效果不明顯,但是在減少尿管重置率、縮短尿管留置時(shí)間、提高患者生活質(zhì)量方面具有重要意義。
[Abstract]:Objective: to compare the urinary catheter replacement rate, urinary retention rate and residual urine volume after extubation in two groups under routine nursing and systemic bladder function exercise, and to explore the effect of systemic bladder function exercise on preventing urinary retention after pelvic floor reconstruction.Through nursing intervention, the incidence of urinary retention was reduced, the replacement rate of urinary catheter was reduced, urinary tract infection was prevented, and the pain of patients was alleviated.Methods: this study was a pilot study in which two different interventions were taken to prevent urinary retention after pelvic floor reconstruction.According to the cluster random principle, the patients in two gynecological areas of a certain hospital were assigned to the experimental group or the control group, 55 cases in each group. The control group was given routine nursing.On the basis of routine nursing, systematic bladder function exercise was carried out in the test group. The intervention time was 3 days before operation until the extubation of urinary catheter was successfully voided. The responsible nurses collected and recorded the replacement rate of urinary catheter and the incidence of urinary retention in the two groups after intervention.Urethral catheter retention time, residual urine volume, urine routine results, body temperature, incidence of bladder irritation and urinary tract infection.All the data were processed by SPSS 21. 0 statistical software.T test was used to compare the measurement data of the two groups, and 蠂 2 test and fisher's exact probability method were used to compare the count data.The result is 1: 1.There were 12 patients in the test group with a resetting rate of 21.82 urinary catheter and 23 patients in the control group. The replacement rate was 41.82%.The difference of urethral replacement rate between the two groups was statistically significant (P 0.05, 蠂 2 = 7.880, P < 0.05).A total of 13 patients in the trial group were confirmed to have urinary retention, with an incidence of 23.64 and 38.18 in the control group.The results showed that the incidence of urinary retention in the two groups was significantly higher than that in the control group (P 0.05, 蠂 2 = 6.714, P < 0.05).The indwelling time of urethral catheter in the test group was 55.14 19.53 and that in the control group was 64.58 21.60 and 2.334g / P 0.05, the difference was statistically significant, and the urinary residual volume was 20.45 27.00 and 30.55 25.44 / 2.017 / P0.05 respectively, which indicated that this method could effectively reduce the retention of urine.The incidence of bladder irritation in the control group (n = 19) was higher than that in the test group (n = 13). The rate of bladder irritation was 34.55 in the control group and 23.64 in the test group.But the analysis found no significant difference between the two groups. 5. 5.The incidence of urinary tract infection in the test group was lower than that in the control group (17.02%). The main judgment method was the number of white blood cells in the urine sediment microscopic examination, but there was no significant difference between the two groups.Conclusion: systematic bladder function training has a good effect on preventing urinary retention after pelvic floor reconstruction. Although it is not effective in preventing urinary tract infection and reducing bladder irritation symptoms, it can reduce the replacement rate of urinary catheter.It is of great significance to shorten the indwelling time of urethral catheter and improve the quality of life of patients.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R473.6

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 阮利;白雪;伍小莉;黎曉慶;王珍明;;康復(fù)護(hù)理對(duì)宮頸癌根治術(shù)患者膀胱功能及下肢水腫的影響[J];中國(guó)腫瘤臨床與康復(fù);2017年02期

2 唐亞萍;;宮頸癌手術(shù)后尿潴留的臨床分析[J];臨床醫(yī)學(xué)研究與實(shí)踐;2017年02期

3 劉思婷;常捷芳;;Crede手法配合膀胱功能訓(xùn)練對(duì)宮頸癌根治術(shù)后尿潴留患者的護(hù)理效果[J];中國(guó)腫瘤臨床與康復(fù);2017年01期

4 王心平;周玲;;個(gè)體化指導(dǎo)及訓(xùn)練對(duì)全子宮切除后尿潴留的影響[J];江蘇醫(yī)藥;2016年22期

5 楊振杰;肖學(xué)偉;;電針陰陵泉、三陰交穴對(duì)宮頸癌根治術(shù)后尿潴留療效對(duì)比研究[J];亞太傳統(tǒng)醫(yī)藥;2016年22期

6 齊英;黃佳妮;李紅;高偉;顧梅花;李旖茲;吳曉蓉;;膀胱功能訓(xùn)練預(yù)防婦科良性疾病術(shù)后患者尿潴留的效果[J];新鄉(xiāng)醫(yī)學(xué)院學(xué)報(bào);2016年11期

7 姚健平;;產(chǎn)后尿潴留的發(fā)生原因及防范處理進(jìn)展[J];護(hù)理實(shí)踐與研究;2016年21期

8 高紅梅;;分析在改善子宮切除術(shù)后患者排尿功能中綜合護(hù)理干預(yù)的作用[J];世界最新醫(yī)學(xué)信息文摘;2016年66期

9 梅雪峰;田英;夏雨果;趙娟;張闖;曾文彤;;不同時(shí)間段口服鹽酸坦索羅辛在預(yù)防椎管麻醉術(shù)后尿潴留中的作用[J];世界最新醫(yī)學(xué)信息文摘;2016年59期

10 莊荔凰;黃少鵬;陳玉娟;;中醫(yī)特色護(hù)理預(yù)防肛腸科病人術(shù)后尿潴留的效果觀察[J];全科護(hù)理;2016年17期

相關(guān)碩士學(xué)位論文 前6條

1 胡力云;導(dǎo)尿管相關(guān)尿路感染預(yù)防指南的循證實(shí)踐研究[D];北京中醫(yī)藥大學(xué);2016年

2 張珂銘;盆底肌生物反饋電刺激治療脊髓損傷所致神經(jīng)源性膀胱療效的臨床研究[D];重慶醫(yī)科大學(xué);2016年

3 周亞丹;新式盆底重建術(shù)與傳統(tǒng)手術(shù)治療盆腔器官脫垂的臨床分析[D];鄭州大學(xué);2014年

4 言哲英;系統(tǒng)性膀胱功能鍛煉對(duì)預(yù)防宮頸癌根治術(shù)后尿潴留的效果研究[D];中南大學(xué);2013年

5 柯桂珠;盆底器官脫垂的動(dòng)態(tài)MRI研究[D];福建醫(yī)科大學(xué);2008年

6 鄧國(guó)忠;按摩足部泌尿反射區(qū)對(duì)腎泌尿功能影響的研究[D];成都中醫(yī)藥大學(xué);2006年

，

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