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

李雪梅; 李雨威; 李珍燕

doi:10.16016/j.1000-5404.201903137

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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

临床医学 | 更新时间：2026-01-09

- 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
- Efficacy of bundle care for improving urinary control in patients after orthotopic ileal neobladder reconstruction
- 第三军医大学学报 2019年41卷第16期页码：1596-1600
- 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，全军泌尿外科研究所
- 作者简介：
  
  [ 李雪梅，E-mail:lixuemeiw@163.com LI Xuemei, E-mail:lixuemeiw@163.com
- 基金信息：
  
  陆军军医大学第一附属医院护理创新课题(SWHLKJ-A04)
- DOI：10.16016/j.1000-5404.201903137
  中图分类号： R743.6; R699.5; R737.14
- 收稿：2019-03-17，
  
  修回：2019-05-05，
  
  纸质出版：2019-08-30
- 稿件说明：
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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.

Xuemei LI, Yuwei LI, Zhenyan LI. Efficacy of bundle care for improving urinary control in patients after orthotopic ileal neobladder reconstruction[J]. Journal of Third Military Medical University, 2019, 41(16): 1596-1600.
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. DOI： 10.16016/j.1000-5404.201903137.

Xuemei LI, Yuwei LI, Zhenyan LI. Efficacy of bundle care for improving urinary control in patients after orthotopic ileal neobladder reconstruction[J]. Journal of Third Military Medical University, 2019, 41(16): 1596-1600. DOI： 10.16016/j.1000-5404.201903137.

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(

0.01)，新膀胱残余尿量明显少于对照组(

0.01)，排尿满意度(日间、夜间)均显著高于对照组(

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.

Methods

Between 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 (

=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

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.

Results

At 3

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 (

0.01) with smaller residual urine volume (

0.01) and better satisfaction with urination both in daytime and at night (

0.05) than those in the control group.

Conclusion

Bundle 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.

关键词

Keywords

references

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