摘要目的 探讨经尿道前列腺电切术(TURP)术后膀胱痉挛的危险因素及集束化护理的干预效果.方法 收集2011年1月—2012年12月120例TURP患者临床资料进行TURP术后膀胱痉挛的危险因素分析,根据分析结果制定集束化护理方案.选择2013年1月—2014年12月TURP患者150例为对照组,给予常规护理;选择2015年1月—2016年12月TURP患者150例为观察组,实施集束化护理.比较两组患者术后膀胱痉挛、尿管堵塞情况和患者满意度.结果 多元回归分析显示,SAS评分、气囊注水量、不稳定膀胱或低顺应性膀胱、术后便秘为TURP术后膀胱痉挛的独立影响因素(OR值分别为1.427、0.092、13.263、27.437;P<0.01).实施集束化护理后,观察组患者术后膀胱痉挛率6.0%,尿管堵塞率5.3%,均低于对照组(28.4%、29.3%),差异有统计学意义(χ2值分别为25.726、30.149;P<0.01);观察组患者术后满意度评分(95.21±4.63)分,高于对照组的(85.7±4.23)分,差异有统计学意义(t=14.469,P<0.01).结论 集束化护理可以降低TURP患者术后膀胱痉挛率和尿管堵塞率,提高术后满意度.

abstractsObjective To investigate the risk factors of bladder spasm after transurethral resection of the prostate (TURP) and the intervention effect of cluster nursing. Methods From January 2011 to December 2012, the clinical data of 120 cases of TURP patients were analyzed for the risk factors of bladder spasm after TURP. According to the results of the analysis, cluster nursing plan was constructed. The 150 TURP patients from January 2013 to December 2014 were selected as the control group and given routine nursing care. The 150 TURP patients from January 2015 to December 2016 were recruited as the observation group and given cluster nursing. The postoperative bladder spasm, catheter blockage and patients satisfaction were compared between the two groups. Results The results of the multivariate regression analysis indicated that the score of Self-rating Anxiety Scale, air bag water injection, unstable bladder or low compliance bladder, and postoperative constipation were independent factors of bladder spasm after TURP (OR=1.427, 0.092, 13.263, 27.437; P<0.01). After the implementation of cluster nursing, the postoperative bladder spasm rate was 6.0%, and the catheter blockage rate was 5.3%, which were both lower than those of the control group (28.4%,29.3%), and the differences were statistically significant (χ2=25.726, 30.149; P<0.01). The patient postoperative satisfaction of the observation group was (95.21±4.63), which was higher than that of the control group (85.76±4.23), and the difference was statistically significant (t=14.469, P<0.01). Conclusions Cluster nursing can reduce the rate of bladder spasm and catheter blockage after TURP, and increase patients' satisfaction after surgery.