经尿道前列腺等离子汽化术后膀胱痉挛护理.docVIP

经尿道前列腺等离子汽化术后膀胱痉挛护理[摘要] 目的 探讨经尿道前列腺等离子汽化术(PKVP)后使用持续硬膜外镇痛泵(PCEA)和膀胱冲洗液温度对膀胱痉挛的影响。方法 随机选取良性前列腺增生症患者100例,行经尿道前列腺等离子汽化术,术后持续膀胱冲洗3d、部分病例留置持续硬膜外镇痛泵2d。排除窦性心动过速、窦性心动过缓患者。排除术前控制收缩压140mmHg患者。研究对象分组:第1组:使用术后持续镇痛泵50例;第2组:不使用术后持续镇痛泵50例;术后持续膀胱冲洗液采用生理盐水,根据冲洗液温度不同将每组患者随机分为4小组:15、20、25、30℃。观察患者生命体征、尿隐血、膀胱痉挛,同时进行心理护理。结果 ①使用PCEA组心率和收缩压明显低于未使用PCEA组,每组心率与收缩压随着膀胱痉挛次数的增多而增高。12、24、36和48h四组心率及收缩压比较无明显差别。使用PCEA组尿隐血明显低于未使用PCEA组。使用PCEA组和未使用PCEA组频发膀胱痉挛(≥15次)比例分别为16%和60%,两者比较差异有统计学意义。②无论是否使用PCEA,四组不同温度组中25℃组膀胱痉挛发生率最低,差异有统计学意义(P0.05)。结论 ①PKVP术后使用PCEA可有效缓解膀胱痉挛;②PKVP术后持续膀胱冲洗液温度25℃可以缓解膀胱痉挛。 [关键词] 经尿道前列腺等离子汽化术;膀胱痉挛;护理 [中图分类号] R473.6 [文献标识码] A[文章编号] 1673-9701(2009)34-59-03 Nursing of Cystospasm after Plasmakinetic Vaporesection of the Prostate ZHOU Jiao Operation Room,the Affiliated Hospital of Jiangsu Univercity,Zhenjiang 212001,China [Abstract] Objective To investigate the role of PCEA and the lavage temperature of bladder on the control of cystospasm after plasmakinetic vaporesection of the prostate. Methods 100 BPH patients who underwent plasmakinetic vaporesection of the prostate were random separated into 2 parts.The lavage of bladder in every case was stopped in three days,and PECA which were fixed in 50 cases was stopped in two days.The 100 cases were also divided into four parts according to the lavage temperature of bladder. (15℃、20℃、25℃、30℃)The heart rate,blood pressure,cystospasm and routine urine examination were determined. Mental nursing was performed in every case. Results ①Compared with the heart rate and blood pressure in PECA control,they were significantly higher in the non-PECA ones. Both the rate of cystospasm and the occult blood in urine were significant lower in the PECA control than in the non-PECA control. ②The rate of cystospasm was significantly lowest in the 25℃ control. ③There was no difference in all the cases on the mental nursing. Conclusion ①The PECA is helpful for the anesis of cystospasm after PKVP. ②It is beneficial for the anesis of cystospasm