[1]李雪梅,李雨威,李珍燕.集束化护理干预在改善正位回肠膀胱术后患者尿控中的应用[J].第三军医大学学报,2019,41(16):1596-1600.
 LI Xuemei,LI Yuwei,LI Zhenyan.Efficacy of bundle care for improving urinary control in patients after orthotopic ileal neobladder reconstruction[J].J Third Mil Med Univ,2019,41(16):1596-1600.
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集束化护理干预在改善正位回肠膀胱术后患者尿控中的应用(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
41卷
期数:
2019年第16期
页码:
1596-1600
栏目:
临床医学
出版日期:
2019-08-30

文章信息/Info

Title:
Efficacy of bundle care for improving urinary control in patients after orthotopic ileal neobladder reconstruction
作者:
李雪梅李雨威李珍燕
陆军军医大学(第三军医大学)第一附属医院泌尿外科,全军泌尿外科研究所
Author(s):
LI Xuemei LI Yuwei LI Zhenyan

Institute of Urology, First Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China

关键词:
集束化护理正位回肠膀胱术膀胱癌排尿功能
Keywords:
bundle care orthotopic ileal neobladder reconstruction bladder cancer urination function
分类号:
R743.6;R699.5;R737.14
文献标志码:
A
摘要:

目的 探讨集束化护理干预对膀胱全切正位回肠膀胱术后患者尿控能力的改善效果。方法收集本院2014年1月至2016年12月收治的膀胱癌行根治性膀胱全切正位回肠膀胱术后出院的60例患者,按随机数字表法分为对照组30例和研究组30例。对照组在患者出院时行常规出院指导,研究组在对照组基础上采取以指导盆底肌锻炼、变换体位排尿、Valsalva呼吸增大腹压、记录排尿日记为整体的集束化护理干预措施。观察两组患者术后3、6、12个月尿动力学检测指标:最大尿流率、平均尿流率、新膀胱容量、新膀胱残余尿量、肾功能情况及患者的日间夜间排尿满意度。结果术后3、6、12个月,研究组患者的最大尿流率、平均尿流率、新膀胱容量均显著大于对照组(P<0.01),新膀胱残余尿量明显少于对照组(P<0.01),排尿满意度(日间、夜间)均显著高于对照组(P<0.05)。结论集束化护理可有效改善膀胱全切正位回肠膀胱术后患者尿控能力,促进新膀胱功能恢复,值得在临床护理工作中推广。

Abstract:
Objective To assess the efficacy of bundle care for improving postoperative urinary control in patients receiving radical cystectomy and orthotopic ileal neobladder reconstruction. MethodsBetween January, 2014 and December, 2016, 60 patients with bladder cancer undergoing radical cystectomy and orthotopic ileal neobladder reconstruction in our department were randomly assigned into control group and bundle care group (n=30). In the control group, the patients were provided with routine instructions and training at discharge, and those in the bundle care group received additional interventions including training of the pelvic floor muscles and trainings for changing the manner of urination, increasing abdominal pressure by Valsalva breathing during urination, and keeping the voiding diary. The patients were followed up regularly and at 3, 6, and 12 months after the surgery, the urine dynamics, maximum and mean urinary flow rate, neobladder capacity and residual urine volume, renal functions and patient’s satisfaction with urination were assessed and compared between the two groups. ResultsAt 3, 6, and 12 months after the surgery, the patients in the bundle care group showed significantly greater maximum and mean urinary flow rate and neobladder capacity (P<0.01) with smaller residual urine volume (P<0.01) and better satisfaction with urination both in daytime and at night (P<0.05) than those in the control group. ConclusionBundle care interventions can effectively improve postoperative urinary control and promote functional recovery of the neobladder in patients receiving radical cystectomy and orthotopic ileal neobladder reconstruction for bladder cancer.
 
更新日期/Last Update: 2019-08-22