艾灸联合行动导向教学法对泌尿系结石留置输尿管支架患者的影响

彭静; 孙剑虹; 吴剑; 叶佳佳

doi:10.16766/j.cnki.issn.1674-4152.004190

艾灸联合行动导向教学法对泌尿系结石留置输尿管支架患者的影响

doi: 10.16766/j.cnki.issn.1674-4152.004190

彭静¹,
孙剑虹²,
吴剑^3, ,,
叶佳佳¹

1.
台州市中西医结合医院泌尿结石科，浙江台州 317500
2.
绍兴市人民医院泌尿外科(结石)，浙江绍兴 312000
3.
台州市中西医结合医院普外科

基金项目:

浙江省医药卫生科技计划项目 2024KY464

温岭市科技项目 2022S00056

详细信息

通讯作者:
吴剑，E-mail：490902869@qq.com

中图分类号: R473.6 R691.4
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- 文章访问数: 3
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出版历程
- 收稿日期: 2024-11-05
- 网络出版日期: 2025-11-17

The effect of moxibustion combined with action oriented teaching method on patients with urolithiasis and ureteral stent placement

1.
Department of Urolithiasis, Taizhou Integrated Traditional Chinese and Western Medicine Hospital, Taizhou, Zhejiang 317500, China

摘要

摘要: 目的观察艾灸联合行动导向教学法在泌尿系结石术后留置输尿管支架患者中的应用效果，分析其对患者胃肠功能恢复、输尿管支架症状评分、自我管理能力等情况的影响。方法选取2021年3月—2024年3月台州市中西医结合医院收治的112例行钬激光碎石术后留置双J管患者，采用随机数字表法为对照组(56例)和观察组(56例)。2组患者术后均进行常规治疗及护理，在此基础上，对照组应用常规健康教育，观察组应用艾灸联合行动导向教学法进行健康教育。对比2组患者术后胃肠功能恢复时间、输尿管支架症状及自我管理能力等情况。结果观察组患者术后首次排气及排便时间分别为(22.21±3.16)h、(1.83±0.21)d, 均短于对照组[(25.58±4.08)h、(1.97±0.26)d, P＜0.05]；观察组输尿管支架症状评分(USSQ)总分为(28.79±3.14)分，低于对照组[(39.66±4.72)分，P＜0.05]；拔管时，观察组成年人健康自我管理能力测评量表(AHSMSRS)总分为(160.52±10.56)分，高于对照组[(124.68±12.77)分，P＜0.05]。结论艾灸联合行动导向教学法能够促进泌尿系结石术后留置输尿管支架患者胃肠功能恢复，提高患者健康自我管理能力，改善患者输尿管支架相关疼痛、下尿路等症状，能够正向调节患者术后状态。
- 泌尿系结石 /
- 输尿管支架 /
- 艾灸 /
- 行动导向教学法 /
- 输尿管支架症状
Abstract: Objective Analyzing the application effect of moxibustion combined with action oriented teaching method in patients with urolithiasis undergoing postoperative ureteral stent placement surgery and who have an indwelling ureteral stent. Furthermore, the study will analyze its impact on patients'gastrointestinal function recovery, ureteral stent symptom score and self-management ability. Methods The random number table method was utilized to divide 112 patients who underwent holmium laser lithotripsy and had double J tube placement at Taizhou Integrated Traditional Chinese and Western Medicine Hospital from March 2021 to March 2024 into two group: the control group and the observation group, with 56 patients in each group. Following the surgical procedure, both groups of patients were administered the standard of care and nursing interventions. The control group received routine health education, while the observation group received a combination of moxibustion and an action-oriented teaching method for health education. A comparison should be made of the postoperative gastrointestinal function recovery time, ureteral stent symptoms and self-management ability between two groups of patients. Results The mean first exhaust and defecation time for patients in the observation group following surgery was (22.21±3.16) hours and (1.83±0.21) days, respectively. These values were significantly lower than those observed in the control group, which had a mean first exhaust and defecation time of (25.58±4.08) hours and (1.97±0.26) days, respectively (P < 0.05). The total score for the ureteral stent symptom score (USSQ) in the observation group was (28.79±3.14) points, which was lower than that of the control group [(39.66±4.72) points, P < 0.05]; During extubating, the total score of the adult health self-management skill rating scale (AHSMSRS) in the observation group was (160.52±10.56) points, which was higher than of the control group [(124.68±12.77) points, P < 0.05]. Conclusion The combination of moxibustion and an action-oriented teaching method has been demonstrated to promote the recovery of gastrointestinal function and improve the self-management ability of patients with ureteral stent placement after urolithiasis surgery. It has been demonstrated that the treatment can also improve symptoms such as pain related to ureteral stents and lower urinary tract symptoms. Furthermore, it has been shown to positively regulate the postoperative status of patients.
- Urolithiasis /
- Ureteral stent /
- Moxibustion /
- Action oriented teaching method /
- Symptoms of ureteral stent

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表 1 2组泌尿系结石术后留置输尿管支架患者一般资料比较

Table 1. Comparison of general information between two groups of patients with ureteral stent placement after urolithiasis surgery

项目	对照组(n=56)	观察组(n=56)	统计量	P值
性别(例)			0.078^a	0.781
男性	48	49
女性	8	7
年龄(x±s，岁)	42.86±4.57	43.20±5.14	0.370^b	0.712
受教育年限(x±s，年)	12.66±3.15	12.74±3.42	0.129^b	0.898
BMI(x±s)	22.50±2.63	22.47±2.58	0.061^b	0.951
结石大小(x±s，mm)	10.16±2.17	10.22±2.43	0.138^b	0.891
双J管放置侧别(例)			0.354^a	0.552
左侧	35	38
右侧	21	18
入院诊断(例)			0.167^a	0.919
肾结石	34	36
输尿管结石	15	14
其他	7	6
注：^a为χ²值，^b为t值。

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表 2 2组泌尿系结石术后留置输尿管支架患者胃肠功能恢复时间比较(x±s)

Table 2. Comparison of gastrointestinal function recovery time between two groups of patients with ureteral stent placement after urolithiasis surgery(x±s)

组别	例数	术后首次排气时间(h)	术后首次排便时间(d)
对照组	56	25.58±4.08	1.97±0.26
观察组	56	22.21±3.16	1.83±0.21
t值		4.887	2.926
P值		＜0.001	0.004

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表 3 2组泌尿系结石术后留置输尿管支架患者输尿管支架症状评分比较(x±s，分)

Table 3. Comparison of symptom score of ureteral stent in two groups of patients with ureteral stent placement after urolithiasis surgery(x±s, points)

组别	例数	排尿症状		躯体疼痛		一般健康状况		工作表现		总分
组别	例数	插管前	取管前1 d	管前	取管前1 d	插管前	取管前1 d	插管前	取管前1 d	插管前	取管前1 d
对照组	56	22.19±3.11	9.13±1.59	25.27±2.99	10.62±2.51	14.89±1.81	9.14±2.05	11.26±2.00	8.17±1.22	75.82±6.08	39.66±4.72
观察组	56	21.85±2.97	7.02±1.14	25.40±3.12	8.77±1.26	15.04±2.03	7.67±1.13	11.41±1.95	6.24±0.93	76.71±6.85	28.79±3.14
统计量		0.592^a	7.633^b	0.225^a	8.209^b	0.413^a	7.542^b	0.402^a	10.187^b	0.727^a	13.265^b
P值		0.555	＜0.001	0.822	＜0.001	0.681	＜0.001	0.689	＜0.001	0.469	＜0.001
注：^a为t值，^b为F值。

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表 4 2组泌尿系结石术后留置输尿管支架患者自我管理能力比较(x±s，分)

Table 4. Comparison of self management abilities between two groups of patients with ureteral stent placement after urolithiasis surgery(x±s, points)

组别	例数	自我管理行为		自我管理认知		自我管理环境		总分
组别	例数	入院时	拔管时	入院时	拔管时	入院时	拔管时	入院时	拔管时
对照组	56	30.28±4.11	40.16±5.80	29.73±6.15	42.96±4.24	32.18±3.26	38.77±4.99	97.85±10.24	124.68±12.77
观察组	56	29.75±3.64	55.28±3.77	30.28±5.88	57.73±5.19	32.64±4.01	42.59±3.07	98.49±9.73	160.52±10.56
统计量		0.722^a	14.588^b	0.484^a	15.291^b	0.666^a	4.316^b	0.339^a	15.837^b
P值		0.472	＜0.001	0.630	＜0.001	0.507	＜0.001	0.735	＜0.001
注：^a为t值，^b为F值。

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