多学科合作干预对广泛性全子宫切除术后患者膀胱功能恢复的影响
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摘要
目的探讨多学科合作干预促进广泛性全子宫切除术后患者膀胱功能恢复的临床效果。方法将150例广泛性全子宫切除术患者按住院时间分为对照组与观察组各75例。对照组实施常规护理,观察组在对照组的基础上给予多学科合作干预。比较两组术后尿管留置时间、泌尿系感染发生率;术后1个月进行膀胱功能评估量表评分、残余尿测定及尿动力学检测。结果观察组术后尿管留置时间显著短于对照组,泌尿系感染发生率显著低于对照组(P<0.05,P<0.01);术后1个月观察组膀胱功能恢复程度、最大尿流率、逼尿肌收缩力、最大膀胱容量显著优于对照组,膀胱功能评分显著低于对照组(P<0.05,P<0.01)。结论多学科合作干预可促进广泛性全子宫切除术后患者膀胱功能恢复。
Objective To explore the clinical effect of multidisciplinary intervention on recovery of bladder function in patients after total extensive hysterectomy.Methods A total of 150 patients undergoing extensive hysterectomy were divided into a control group and an observation group according to their hospitalization time,with 75 cases in each group.The control group was given routine care,while the observation group additionally received multidisciplinary intervention.Catheter indwelling time and incidence of urinary tract infection were compared between the two groups.The bladder function score measured using the Measurement of Urinary Handicap(MUH)symptom-scoring questionnaire,amount of residual urine and urodynamics were also evaluated at 1month postoperatively.Results The observation group had significantly shorter catheter indwelling time and lower urinary tract infection rate compared to the control group(P<0.05,P<0.01).The degree of bladder function recovery,maximum urinary flow rate,detrusor contractility and maximum bladder volume were significantly higher,whereas the MUH score was significantly lower in the observation group than those in the control group at 1 month postoperatively(P<0.05,P<0.01).Conclusion Multidisciplinary intervention can promote bladder function recovery of patients after total extensive hysterectomy.
Objective To explore the clinical effect of multidisciplinary intervention on recovery of bladder function in patients after total extensive hysterectomy.Methods A total of 150 patients undergoing extensive hysterectomy were divided into a control group and an observation group according to their hospitalization time,with 75 cases in each group.The control group was given routine care,while the observation group additionally received multidisciplinary intervention.Catheter indwelling time and incidence of urinary tract infection were compared between the two groups.The bladder function score measured using the Measurement of Urinary Handicap(MUH)symptom-scoring questionnaire,amount of residual urine and urodynamics were also evaluated at 1month postoperatively.Results The observation group had significantly shorter catheter indwelling time and lower urinary tract infection rate compared to the control group(P<0.05,P<0.01).The degree of bladder function recovery,maximum urinary flow rate,detrusor contractility and maximum bladder volume were significantly higher,whereas the MUH score was significantly lower in the observation group than those in the control group at 1 month postoperatively(P<0.05,P<0.01).Conclusion Multidisciplinary intervention can promote bladder function recovery of patients after total extensive hysterectomy.
引文
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[12]林小玲,邓惠珍,刘东霞,等.间歇性自我清洁导尿术在宫颈癌术后尿潴留患者中的应用[J].护理学杂志,2016,31(24):58-59.
[13]高杰,张宏,刘莉,等.间歇导尿在宫颈癌根治术后患者膀胱功能康复的应用[J].护理学杂志,2018,33(16):81-83.
[14]王光远,聂婉翎.盆腔肌肉训练联合心理护理干预对宫颈癌根治术后患者尿潴留的影响[J].中华现代护理杂志,2014,49(8):941-943.
[15]宁丹,包丹丹.实施饮水计划对神经源性膀胱的临床意义[J].中国实用乡村医生杂志,2012,19(12):42-43.
[16]逯建娥,张欣然,张国清.尿潴留的原因及处理[J].解放军护理杂志,2000,17(2):15-16.
[17]Swinn M J,Kitchen N D,Goodwin R J,et al.Sacral neuromodulation for women with Fowler′s syndrome[J].Eur Urol,2000,38(4):439-443.
[18]彭秀娟,张永臣,杜广中,等.电针联合中频电疗法预防宫颈癌根治术后尿潴留26例临床回顾性分析[J].江苏中医药,2015,47(3):61-62.
[19]胡艳飞.穴位艾灸预防子宫广泛切除术后尿潴留的效果观察[J].护理与康复,2005,4(4):299-299.
[2]Villalon L,Laporte M,Carrier N.Nutrition screening for seniors in health care facilities:a survey of health professionals[J].Can J Diet Pract Res,2011,72(4):162-169.
[3]陆立,黄林,陆安伟.根治性子宫切除术后下尿路功能障碍病因研究进展[J].中国实用妇科与产科杂志,2011,27(7):558-560.
[4]Plotti F,Angioli R,Zullo M A,et al.Update on urodynamic bladder dysfunctions after radical hysterectomy for cervical cancer[J].Crit Rev Oncol Hemat,2011,80(2):323-329.
[5]Zullo M A,Manci N,Angioli R,et al.Vesical dysfunctions after radical hysterectomy for cervical cancer:a critical review[J].Crit Rev Oncol Hematol,2003,48(3):287-293.
[6]Ralph G,Tamussino K,Lichtenegger W.Urological complications after radical abdominal hysterectomy for cervical cancer[J].Baillières Clin Obstet Gynaecol,1988,2(4):943-952.
[7]蒋慧琴,东梅.慢性病多学科协作模式下的护理现状和展望[J].护理学报,2017,24(22):28-31.
[8]邓运龙.运动训练“节律交替理论”的基本思想[J].沈阳体育学院学报,2007,26(3):1-5.
[9]艾艳.饮水计划在神经源性膀胱功能训练中的作用[J].中华护理杂志,2010,45(7):659-660.
[10]任亚锋,张博爱,冯晓东,等.艾灸治疗脊髓损伤后膀胱功能障碍的临床研究[J].中国中医基础医学杂志,2013(10):1178-1180.
[11]Feyeux C,Mourtialon P,Guyomard A,et al.Plication of suburethral slings as treatment of persisting or recurring stress urinary incontinence[J].Prog Urol,2012,22(16):1033-1038.
[12]林小玲,邓惠珍,刘东霞,等.间歇性自我清洁导尿术在宫颈癌术后尿潴留患者中的应用[J].护理学杂志,2016,31(24):58-59.
[13]高杰,张宏,刘莉,等.间歇导尿在宫颈癌根治术后患者膀胱功能康复的应用[J].护理学杂志,2018,33(16):81-83.
[14]王光远,聂婉翎.盆腔肌肉训练联合心理护理干预对宫颈癌根治术后患者尿潴留的影响[J].中华现代护理杂志,2014,49(8):941-943.
[15]宁丹,包丹丹.实施饮水计划对神经源性膀胱的临床意义[J].中国实用乡村医生杂志,2012,19(12):42-43.
[16]逯建娥,张欣然,张国清.尿潴留的原因及处理[J].解放军护理杂志,2000,17(2):15-16.
[17]Swinn M J,Kitchen N D,Goodwin R J,et al.Sacral neuromodulation for women with Fowler′s syndrome[J].Eur Urol,2000,38(4):439-443.
[18]彭秀娟,张永臣,杜广中,等.电针联合中频电疗法预防宫颈癌根治术后尿潴留26例临床回顾性分析[J].江苏中医药,2015,47(3):61-62.
[19]胡艳飞.穴位艾灸预防子宫广泛切除术后尿潴留的效果观察[J].护理与康复,2005,4(4):299-299.