神经源性膀胱患儿行回肠浆肌层代膀胱扩容术围术期护理
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摘要
目的:探讨神经源性膀胱(NB)患儿行回肠浆肌层代膀胱扩容术的围术期护理方法和效果。方法:将83例NB患儿按入院先后顺序随机分为对照组41例和观察组42例,对照组采用常规护理措施,观察组在对照组护理基础上进行围术期护理干预,比较两组护理效果。结果:干预后观察组患儿排尿次数、夜尿次数、尿失禁次数均少于对照组(P <0. 05);观察组患儿未见泌尿系感染,对照组泌尿系统感染发生率为9. 76%,两组比较差异有统计学意义(P <0. 05);观察组患儿随访时间长于对照组(P <0. 05)。结论:对行回肠浆肌层代膀胱扩容术的NB患儿实施围术期护理干预,能够改善患儿术后尿失禁临床症状,有利于减少并发症发生,延长随访时间。
Objective: To explore the perioperative nursing methods and effects of ileal seromuscular layer for bladder dilatation surgery for children with neurogenic bladder( NB). Methods: A total of 83 children with NB were randomly divided into control group( n = 41) and observation group( n = 42) according to the order of admission. Routine nursing measures were used in the control group,and perioperative nursing intervention was carried out in the observation group on the basis of nursing in the control group. Results: The frequency of urination,nocturia and urinary incontinence in the observation group were less than those in the control group( P < 0. 05). No urinary tract infection was found in the observation group,and the incidence of urinary tract infection in the control group was 9. 76%. The difference between the two groups was statistically significant( P < 0. 05). The follow-up time of the observation group was longer than that of the control group( P < 0. 05). Conclusion: Perioperative nursing intervention can improve the clinical symptoms of postoperative urinary incontinence in children with NB undergoing ileal seromuscular layer for bladder dilatation surgery,which is beneficial to reduce the incidence of complications and prolong the follow-up time.
Objective: To explore the perioperative nursing methods and effects of ileal seromuscular layer for bladder dilatation surgery for children with neurogenic bladder( NB). Methods: A total of 83 children with NB were randomly divided into control group( n = 41) and observation group( n = 42) according to the order of admission. Routine nursing measures were used in the control group,and perioperative nursing intervention was carried out in the observation group on the basis of nursing in the control group. Results: The frequency of urination,nocturia and urinary incontinence in the observation group were less than those in the control group( P < 0. 05). No urinary tract infection was found in the observation group,and the incidence of urinary tract infection in the control group was 9. 76%. The difference between the two groups was statistically significant( P < 0. 05). The follow-up time of the observation group was longer than that of the control group( P < 0. 05). Conclusion: Perioperative nursing intervention can improve the clinical symptoms of postoperative urinary incontinence in children with NB undergoing ileal seromuscular layer for bladder dilatation surgery,which is beneficial to reduce the incidence of complications and prolong the follow-up time.
引文
[1] Salomon J,Gory A,Bernard L,et al. Urinary tract infection and neurogenic bladder[J]. Urologic Clinics of North America,2015,42(4):527-536.
[2]范天伦,符川,王声兴,等.神经源性膀胱功能障碍患者不同治疗效果评价[J].中国公共卫生,2016,32(7):978-980.
[3] Probst M,Piechota HJ,Dahiya R,et al. Homologous bladder augmentation in dog with the bladder acellular matrix graft[J]. Bju International,2015,85(3):362-371.
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[6]杜耀军,刘路然,刘畅,等.神经源性膀胱引起排尿障碍的疗效观察[J].医学研究杂志,2015,43(7):149-151.
[7]付光,吴娟,丛慧玲,等.不同剂量A型肉毒素经尿道膀胱壁注射治疗脊髓损伤患者神经源性尿失禁的疗效对比[J].中华医学杂志,2015,95(48):3920-3923.
[8] Vigil HR,Hickling DR. Urinary tract infection in the neurogenic bladder[J]. Translational Andrology&Urology,2016,5(1):72.
[9]尹平,郑慧敏,汤康敏,等.针灸治疗神经源性膀胱的临床研究进展[J].中医药导报,2016,22(17):62-65.
[10] Kroll P,Zachwieja J. Complications of untreated and ineffectively treated neurogenic bladder dysfunctions in children:our own practical classification[J]. Eur Rev Med Pharmacol Sci,2016,20(7):1229-1237.
[11]陈忠,杨为民.神经源性膀胱的诊疗进展[J].临床外科杂志,2016,24(2):85-88.
[12]冯俊铎,黄莉娟,丁立新,等.中枢神经系统损伤并发神经源性膀胱的研究进展[J].临床泌尿外科杂志,2015,25(11):1057-1059.
[13] Sinha S. Follow-up urodynamics in patients with neurogenic bladder[J]. Indian Journal of Urology Journal of the Urological Society of India,2017,33(4):267-275.
[14]李泸平,范应中,李浩,等.膀胱扩大术联合康复训练治疗反射亢进型神经源性膀胱[J].中国修复重建外科杂志,2016,30(2):224-228.
[15]蔡文智,陈思婧.神经源性膀胱护理指南[J].中华护理杂志,2011,46(1):104-108.
[2]范天伦,符川,王声兴,等.神经源性膀胱功能障碍患者不同治疗效果评价[J].中国公共卫生,2016,32(7):978-980.
[3] Probst M,Piechota HJ,Dahiya R,et al. Homologous bladder augmentation in dog with the bladder acellular matrix graft[J]. Bju International,2015,85(3):362-371.
[4] Sanford MT,Suskind AM. Neuromodulation in neurogenic bladder[J]. Translational Andrology&Urology,2016,5(1):117.
[5]刘小荣,付倩.小儿神经源性膀胱诊断与治疗[J].中国实用儿科杂志,2015,25(4):253-257.
[6]杜耀军,刘路然,刘畅,等.神经源性膀胱引起排尿障碍的疗效观察[J].医学研究杂志,2015,43(7):149-151.
[7]付光,吴娟,丛慧玲,等.不同剂量A型肉毒素经尿道膀胱壁注射治疗脊髓损伤患者神经源性尿失禁的疗效对比[J].中华医学杂志,2015,95(48):3920-3923.
[8] Vigil HR,Hickling DR. Urinary tract infection in the neurogenic bladder[J]. Translational Andrology&Urology,2016,5(1):72.
[9]尹平,郑慧敏,汤康敏,等.针灸治疗神经源性膀胱的临床研究进展[J].中医药导报,2016,22(17):62-65.
[10] Kroll P,Zachwieja J. Complications of untreated and ineffectively treated neurogenic bladder dysfunctions in children:our own practical classification[J]. Eur Rev Med Pharmacol Sci,2016,20(7):1229-1237.
[11]陈忠,杨为民.神经源性膀胱的诊疗进展[J].临床外科杂志,2016,24(2):85-88.
[12]冯俊铎,黄莉娟,丁立新,等.中枢神经系统损伤并发神经源性膀胱的研究进展[J].临床泌尿外科杂志,2015,25(11):1057-1059.
[13] Sinha S. Follow-up urodynamics in patients with neurogenic bladder[J]. Indian Journal of Urology Journal of the Urological Society of India,2017,33(4):267-275.
[14]李泸平,范应中,李浩,等.膀胱扩大术联合康复训练治疗反射亢进型神经源性膀胱[J].中国修复重建外科杂志,2016,30(2):224-228.
[15]蔡文智,陈思婧.神经源性膀胱护理指南[J].中华护理杂志,2011,46(1):104-108.