两种不同尿道支架管冲洗方法对小儿尿道下裂术后并发症的护理研究
Nursing study of two different urethral stent flush methods for postoperative complications of hypospadias repair in children patients
目的 探讨2种不同尿道支架管冲洗方法对小儿尿道下裂术后并发症的影响.方法将2014年3月至2016年3月182例接受带蒂双面包皮皮瓣尿道成形术的患儿按照随机数字表法分为干预组89例和对照组93例.对照组共92例完成研究,按常规用庆大霉素冲洗尿道支架管.干预组共87例完成研究,采用庆大霉素冲洗尿道支架管并在术后第4天训练患儿每日从尿道支架管排尿2次冲洗尿道支架管.评估2组患儿术后1年内尿瘘、尿道狭窄的发生率及患儿照顾者的焦虑程度.结果干预组与对照组患儿尿瘘发生率分别为5.7%(5/87)、15.2%(14/92),差异有统计学意义(χ2=4.227,P<0.05);干预组患儿照顾者的焦虑程度(无焦虑33例占37.9%,轻度焦虑42例占48.3%,中度焦虑8例占9.2%,重度焦虑4例占4.6%)低于对照组(无焦虑21例占22.8%,轻度焦虑46例占50.0%,中度焦虑12例占13.0%,重度焦虑13例占14.1%),差异有统计学意义(Z=2.757,P<0.01).结论尿道下裂术后采用尿道支架管早期自主排尿冲洗尿道支架管,可显著减少术后尿瘘的发生,减轻患儿照顾者的焦虑程度.
更多Objective To explore the effect of two different urethral stent flush methods for postoperative complications of hypospadias repair in children patients. Methods A total of 182 cases of children patients who underwent urethroplasty with pedicled double skin flaps from March 2014 to March 2016 were divided into intervention group (n=89) and the control group (n=93) by using random number method. The control group was treated with gentamicin irrigation urethral stent;the intervention group was treated with gentamicin irrigation urethral stent, and the patients were trained to urinate twice with the stent from the fourth day after surgery. The incidence of urinary fistula and urethral stricture within one year after surgery, and the anxiety level of patients' caregivers were assessed. Results The incidence of urinary fistula in the intervention group and the control group were 5.7%(5/87) vs. 15.2%(14/92), and the difference was statistically significant(χ2=4.227, P<0.05). In the intervention group, the cases of non anxiety, mild anxiety, moderate anxiety and severe anxiety respectively were 33(37.9%), 42(48.3%), 8 (9.2%) and 4(4.6%). However, in the control group the cases were 21(22.8%), 46(50.0%), 12(13.0%), 13 (14.1%) respectively. The anxiety degree of patients' caregivers was significantly different between intervention group and control group (Z=2.757, P<0.01). Conclusions The training of early micturition with stent after hypospadias surgery can significantly reduce the incidence of urinary fistula and the anxiety level of caregivers.
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