Research of cluster intervention strategy on postoperative bleeding of elderly patients undergoing transurethral resection of the prostate and its prevention on bladder spasm
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摘要: 目的 探讨集束化干预策略对老年经尿道前列腺电切术(TURP)后出血的影响及对患者膀胱痉挛的预防作用。 方法 选取2015年1月-2016年6月于空军军医大学西京医院择期行TURP的86例老年良性前列腺增生症患者,按随机数字表法分成对照组与干预组,每组43例。对照组予常规TURP围术期护理,干预组予集束化干预护理。监测2组患者尿动力学指标,评估2组患者的生活质量及前列腺症状,统计2组患者术后出血、膀胱痉挛的情况以及临床效果。对数据进行统计分析,进而评估集束化干预策略在改善老年患者TURP后出血及预防膀胱痉挛的作用。 结果 护理后,2组Qmax水平显著升高(P<0.05),RU、IPSS评分均显著降低(均P<0.05);而且干预组Qmax水平显著高于对照组(P<0.05),干预组RU、IPSS评分均显著降低于对照组(均P<0.05)。护理后,干预组躯体功能、心理功能及社会功能评分均显著高于对照组(均P<0.05)。护理后,干预组出血、膀胱痉挛情况均明显优于对照组(均P<0.05)。干预组的临床总有效率明显高于对照组(P<0.05)。 结论 集束化干预策略能有效提高老年TURP临床效果,改善术后排尿障碍,并减少术后出血、膀胱痉挛等并发症的发生,从而提高术后生活质量,值得推广。Abstract: Objective To investigate the preventive effect of cluster intervention strategy on postoperative bleeding of elderly patients undergoing transurethral resection of the prostate (TURP) and its prevention on bladder spasm. Methods A total of 86 elderly patients with BPH undergoing TURP in our hospital from January, 2015 to June, 2016 were selected and randomly divided into control group and intervention group, with 43 cases in each group. The control group received routine TURP perioperative nursing, and intervention group received cluster intervention strategy. The urodynamic indicators of two groups were monitored, the life quality and prostate symptom of two groups were assessed, postoperative bleeding, bladder spasm, and clinical effect of two groups were accounted. The data was analyzed to assessed the effect of cluster intervention strategy on postoperative bleeding of elderly patients undergoing TURP and its prevention on bladder spasm. Results After nursing, the Qmax levels of two groups were significantly increased (P<0.05), the RU, IPSS scores of two groups were significantly reduced (all P<0.05); the Qmax level of intervention group was significantly higher than that of control group (P<0.05), and RU,IPSS scores of intervention group was significantly lower than that of control group (all P<0.05). After nursing, physical function, psychological function and social function scores of intervention group were significantly higher than those of control group (all P<0.05). After nursing, hemorrhage and bladder spasm of intervention group were significantly better than those of control group (all P<0.05). The total clinical efficiency of intervention group was significantly better than that of control group (P<0.05). Conclusion The cluster intervention strategy could effectively improve the clinical effect of elderly patients undergoing TURP, improve postoperative urination disorders, and reduce postoperative bleeding, bladder spasm and other complications, thereby improving the life quality, and worthy of promotion.
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