随机对照研究早期综合护理干预在预防正位回肠膀胱术后患者尿潴留中的价值

李雪梅; 李雨威; 李珍燕; 陈志文

doi:10.16016/j.1000-5404.201710035

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随机对照研究早期综合护理干预在预防正位回肠膀胱术后患者尿潴留中的价值

临床医学 | 更新时间：2026-03-02

- 随机对照研究早期综合护理干预在预防正位回肠膀胱术后患者尿潴留中的价值
- Efficacy of early comprehensive nursing care for preventing urinary retention in patients with orthotopic ileal neobladder: a randomized controlled trial
- 第三军医大学学报 2018年40卷第4期页码：362-366
- 作者机构：
  
  400038 重庆，陆军军医大学(第三军医大学)第一附属医院泌尿外科Department of Urology, First Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China
- 作者简介：
- 基金信息：
- DOI：10.16016/j.1000-5404.201710035
  中图分类号： R473.6;R619;R694.55
- 收稿：2017-10-11，
  
  纸质出版：2018-02-28
- 稿件说明：
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李雪梅, 李雨威, 李珍燕, 等. 随机对照研究早期综合护理干预在预防正位回肠膀胱术后患者尿潴留中的价值[J]. 第三军医大学学报, 2018,40(4):362-366.

Xuemei LI, Yuwei LI, Zhenyan LI, et al. Efficacy of early comprehensive nursing care for preventing urinary retention in patients with orthotopic ileal neobladder: a randomized controlled trial[J]. Journal of Third Military Medical University, 2018, 40(4): 362-366.
李雪梅, 李雨威, 李珍燕, 等. 随机对照研究早期综合护理干预在预防正位回肠膀胱术后患者尿潴留中的价值[J]. 第三军医大学学报, 2018,40(4):362-366. DOI： 10.16016/j.1000-5404.201710035.

Xuemei LI, Yuwei LI, Zhenyan LI, et al. Efficacy of early comprehensive nursing care for preventing urinary retention in patients with orthotopic ileal neobladder: a randomized controlled trial[J]. Journal of Third Military Medical University, 2018, 40(4): 362-366. DOI： 10.16016/j.1000-5404.201710035.

摘要

目的

采用随机对照研究

探讨早期综合护理干预在预防正位回肠膀胱术后患者尿潴留中的应用价值。

方法

连续纳入2014年10月至2016年10月因膀胱癌于我科行根治性膀胱全切正位回肠膀胱术的患者60例，按随机数字表法分为实验组和对照组，各30例。对照组接受常规护理，实验组在常规护理的基础上实施早期综合护理干预(包括心理干预、行为干预和认知干预等)，分别在术后3、6、12个月随访时统计患者排尿日记记录情况及尿潴留相关预防措施(包括定时排尿、蹲式排尿、Valsalva呼吸式排尿、提肛运动)的完成情况，记录患者B超下残余尿量和尿潴留的发生率，对结果进行统计分析。

结果

实验组患者术后3、6、12个月总体随访项目完成率均高于对照组(87.3%、83.0%、72.8%

55.5%、51.2%、44.2%；

0.01)；实验组患者术后12个月排尿日记完成率，术后3个月和6个月定时排尿、Valsalva呼吸式排尿完成率，以及整个随访期间蹲式排尿和提肛运动的完成率均明显高于对照组(

0.05)；实验组患者术后3次随访时B超下测得残余尿量及尿潴留的发生率较对照组明显降低(

0.05)。

结论

早期综合护理干预可提高正位回肠膀胱术后患者院外依从性，降低残余尿量及尿潴留的发生率。

Abstract

Objective

To assess the value of early comprehensive nursing care in preventing urinary retention in patients with orthotopic ileal neobladder.

Methods

This randomized controlled trial was conducted among 60 patients with bladder cancer undergoing radical cystectomy and orthotopic ileal neobladder reconstruction in our department between October

2014 and October

2016. The patients were randomized into control group (

=30) and experimental group (

=30) to receive routine nursing and early comprehensive nursing interventions (including psychological

behavioral and cognitive interventions) on the basis of routine nursing

respectively. At 3

6 and 12 months after the operation

all the patients were assessed for completion of urinary diary and fulfilment of the preventive measures against urinary retention (including regular urination

squatting urination

Valsalva respiratory urination

and contraction of the levator ani muscles)

and the residual urine volume and incidence of retention were compared between the two groups.

Results

At 3

6 and 12 months after the operation

the overall completion rates of the preventive measures were 87.3%

83.0%

and 72.8% in the experimental group

respectively

significantly higher than the rates in the

control group (55.5%

51.2%

and 44.2%

respectively;

0.01). The completion rates of urinary diary at 12 months

regular urination and Valsalva respiratory urination at 3 and 6 months

and squatting urination and levator ani movement during the entire follow-up period were significantly higher in the experimental group than in the control group (

0.05). The residual urine volume and incidence of urinary retention were significantly lower in the experimental group than in the control group in all the 3 follow-up examinations (

0.05).

Conclusion

Early comprehensive nursing care can improve the patient compliance and reduce the residual urine and incidence of urinary retention in patients with orthotopic ileal neobladder

关键词

Keywords

references

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