Q-syte分隔膜无针密闭输液接头在膀胱癌患者术后膀胱冲洗和膀胱灌注中的应用研究
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摘要
目的探讨Q-syte分隔膜无针密闭输液接头在膀胱癌患者术后进行膀胱冲洗和膀胱灌注的效果。方法回顾性分析2015年1月至2016年7月因非肌层浸润性膀胱癌于武汉大学中南医院行经尿道膀胱电切的患者。停止持续膀胱冲洗后,观察组应用Q-syte分隔膜无针密闭输液接头封闭冲洗腔,对照组采用传统方法连接引流袋,比较两组患者舒适度、满意度、尿路感染发生率、停止膀胱冲洗所需时间及行膀胱灌注所需时间。结果共纳入88例患者,其中男性63例(72%),女性25例(28%),平均年龄60.2±4.7岁。两组年龄、性别比、体重指数、合并症发生率差异均无统计学意义(P>0.05)。与对照组相比,病例组患者舒适度(轻度不适:86.4%vs. 25.0%,P<0.001;中度不适:13.6%vs. 52.3%,P<0.001;重度不适:0.0%vs. 22.7%,P=0.001)和患者满意度评分(97.9±2.1 vs. 84.5±3.9,P<0.001)显著提高,尿路感染发生率显著降低(11.4%vs. 29.5%,P=0.034);此外,病例组行膀胱灌注所需时间(50.48±1.78 vs. 207.74±5.41,P<0.001)及停止膀胱冲洗所需时间(141.47±3.25 vs. 205.35±5.17,P<0.001)显著降低,差异均有统计学意义。结论持续膀胱冲洗结束后用Q-syte分隔膜无针密闭输液接头封闭三腔导尿管冲洗腔并进行膀胱灌注,在提高患者舒适度和满意度的同时,可降低尿路感染发生率,还可提高医护人员的工作效率。
Objectives To evaluate the effects of Q-syte separating film needleless closed transfusion connector in flushing chamber of three-cavity urethral catheter. Methods To retrospectively analyze the patients who underwent transurethral resection of bladder tumor for non muscle-invasive bladder cancer from January 2015 to July 2016 in Zhongnan Hospital of Wuhan University. After terminating the continuous bladder irrigation, the observed group used Q-syte separating film needleless closed transfusion connector to seal the flushing chamber of three-cavity urethral catheter, and control group used conditional approach to connect drainage bag. The degree of comfort and satisfaction of patients, urinary tract infection, time of stopping bladder irrigation and bladder perfusion time between two groups were assessed. Results A total of 88 patients were included involving 63(72%) males and 25(28%) females with a mean age of 60.2±4.7 years. There were no significant differences between two groups in age, gender, BMI, and complications(P>0.05).Compared to control group, case group had higher level of comfort degree(mild discomfort: 86.4% vs. 25.0%, P<0.001;moderate discomfort: 13.6% vs. 52.3%, P<0.001; severe discomfort: 0.0% vs. 22.7%, P=0.001), satisfaction degree(97.9±2.1 vs. 84.5±3.9, P<0.001), and lower rates of urinary tract infection(11.4% vs. 29.5%, P=0.034). In addition, the case group spent shorter time in terminating bladder irrigation(50.48±1.78 vs. 207.74±5.41, P<0.001) and bladder perfusion(141.47±3.25 vs. 205.35±5.17, P<0.001). All differences were statistical significance. Conclusions Application of Q-syte separating film needleless closed transfusion connector for sealing flushing chamber of three-cavity urethral catheter after continuous bladder irrigation could promote the degree of comfort and satisfaction of patients, and decrease the rate of urinary tract infection, as well as the working efficiency of health care professionals.
Objectives To evaluate the effects of Q-syte separating film needleless closed transfusion connector in flushing chamber of three-cavity urethral catheter. Methods To retrospectively analyze the patients who underwent transurethral resection of bladder tumor for non muscle-invasive bladder cancer from January 2015 to July 2016 in Zhongnan Hospital of Wuhan University. After terminating the continuous bladder irrigation, the observed group used Q-syte separating film needleless closed transfusion connector to seal the flushing chamber of three-cavity urethral catheter, and control group used conditional approach to connect drainage bag. The degree of comfort and satisfaction of patients, urinary tract infection, time of stopping bladder irrigation and bladder perfusion time between two groups were assessed. Results A total of 88 patients were included involving 63(72%) males and 25(28%) females with a mean age of 60.2±4.7 years. There were no significant differences between two groups in age, gender, BMI, and complications(P>0.05).Compared to control group, case group had higher level of comfort degree(mild discomfort: 86.4% vs. 25.0%, P<0.001;moderate discomfort: 13.6% vs. 52.3%, P<0.001; severe discomfort: 0.0% vs. 22.7%, P=0.001), satisfaction degree(97.9±2.1 vs. 84.5±3.9, P<0.001), and lower rates of urinary tract infection(11.4% vs. 29.5%, P=0.034). In addition, the case group spent shorter time in terminating bladder irrigation(50.48±1.78 vs. 207.74±5.41, P<0.001) and bladder perfusion(141.47±3.25 vs. 205.35±5.17, P<0.001). All differences were statistical significance. Conclusions Application of Q-syte separating film needleless closed transfusion connector for sealing flushing chamber of three-cavity urethral catheter after continuous bladder irrigation could promote the degree of comfort and satisfaction of patients, and decrease the rate of urinary tract infection, as well as the working efficiency of health care professionals.
引文
1徐雪芳,赵晓华,吴利和.不同输液接头应用于中心静脉导管相关性血流感染的对比研究.中华医院感染学杂志, 2015, 25(9):2025-2027.
2谢可,曹永,王敏,等.无针正压接头在透析用中心静脉导管护理中的应用.国际护理学杂志, 2017, 36(19):2724-2726.
3尤丽丽,关玉霞,叶维,等.无针密闭接头临床应用的研究进展.中华现代护理杂志, 2017, 23(22):2940-2944.
4 O'Grady NP, Alexander M, Burns LA. Guidelines for the prevention of intravascular catheter-related infections. Clin InfectDis, 2011, 52(9):e162-e193.
5刘桂玲,朱小芳,牛梦铱,等.经尿道膀胱肿瘤切除患者术后尿路感染的高危因素及病原菌分布研究.中华医院感染学杂志,2017, 27(11):2547-2550.
6Naselli A, Puppo P. En Bloc transurethral resection of bladder tumors:a new standard? J Endourol, 2017, 31(S1):S20-S24.
7那彦群.中国泌尿外科疾病诊断治疗指南手册.北京:人民卫生出版社, 2014.
8曹卉娟,邢建民,刘建平.视觉模拟评分法在症状类结局评价测量中的应用.中医杂志, 2009, 50(7):600-602.
9付莲英,段淑云,万水珍.视觉模拟评分法在病人满意度调查中的应用.长治医学院学报, 2012, 8(2):152-153.
10郭庆科,周晶. Likert量表分析中不同IRT模型的有效性.心理学探新, 2004, 24(3):67-70.
11 Pohl F, Hartmann W, Holzmann T, et al. Risk of infection due to medical interventions via central venous catheters or implantable venous access port systems at the middle port of a three-way cock:luer lock cap vs. luer access split septum system(Q-Syte). BMC Infect Dis, 2014, 14:41.
12Adams D, KarpanenT, Worthington T, et al. Infection risk associated with a closed luer access device. J Hosp Infect, 2006,62(3):353-357.
13王建荣.输液治疗护理实践指南与实施细则.北京:人民军医出版社, 2009.
14 贺彩芳,吴雪洁,杨碎丽,等.留置导尿致尿路感染与集尿袋更换时间的相关性研究.中华医院感染学杂志, 2007, 17(4):412-414.
2谢可,曹永,王敏,等.无针正压接头在透析用中心静脉导管护理中的应用.国际护理学杂志, 2017, 36(19):2724-2726.
3尤丽丽,关玉霞,叶维,等.无针密闭接头临床应用的研究进展.中华现代护理杂志, 2017, 23(22):2940-2944.
4 O'Grady NP, Alexander M, Burns LA. Guidelines for the prevention of intravascular catheter-related infections. Clin InfectDis, 2011, 52(9):e162-e193.
5刘桂玲,朱小芳,牛梦铱,等.经尿道膀胱肿瘤切除患者术后尿路感染的高危因素及病原菌分布研究.中华医院感染学杂志,2017, 27(11):2547-2550.
6Naselli A, Puppo P. En Bloc transurethral resection of bladder tumors:a new standard? J Endourol, 2017, 31(S1):S20-S24.
7那彦群.中国泌尿外科疾病诊断治疗指南手册.北京:人民卫生出版社, 2014.
8曹卉娟,邢建民,刘建平.视觉模拟评分法在症状类结局评价测量中的应用.中医杂志, 2009, 50(7):600-602.
9付莲英,段淑云,万水珍.视觉模拟评分法在病人满意度调查中的应用.长治医学院学报, 2012, 8(2):152-153.
10郭庆科,周晶. Likert量表分析中不同IRT模型的有效性.心理学探新, 2004, 24(3):67-70.
11 Pohl F, Hartmann W, Holzmann T, et al. Risk of infection due to medical interventions via central venous catheters or implantable venous access port systems at the middle port of a three-way cock:luer lock cap vs. luer access split septum system(Q-Syte). BMC Infect Dis, 2014, 14:41.
12Adams D, KarpanenT, Worthington T, et al. Infection risk associated with a closed luer access device. J Hosp Infect, 2006,62(3):353-357.
13王建荣.输液治疗护理实践指南与实施细则.北京:人民军医出版社, 2009.
14 贺彩芳,吴雪洁,杨碎丽,等.留置导尿致尿路感染与集尿袋更换时间的相关性研究.中华医院感染学杂志, 2007, 17(4):412-414.