PDCA循环管理在减少输尿管双J管置入术患者术后并发症中应用.docVIP

PDCA循环管理在减少输尿管双J管置入术患者术后并发症中应用 　　摘要：目的：了解泌尿系手术后置入输尿管双J管出现并发症的情况，探究运用PDCA循环管理对病人出现术后并发症的影响。方法：选择近期在我科进行输尿管双J管置入术4周的患者78例，将其分为观察组与对照组，每组39例，对照组患者给予常规医疗处理及护理，而观察组患者则使用PDCA循环管理步骤实施医疗及护理。密切观察两组患者出现并发症情况及护理满意度进行比较。结果：观察组患者对于医疗护理的总满意度（92.29%）明显高于对照组患者的满意度（71.79%）;对照组患者出现血尿、尿频、腰痛、骶尾部不适、管周结石等术后并发症发生率明显高于观察组患者，具有显著性差异（Plt;0.05）。结论：应用PDCA循环管理方法可以减少置入输尿管双J管患者术后并发症的发生率。 　　关键词：PDCA循环管理;输尿管双J管置入;术后并发症 　　Abstract：Objective： To know the clinical situations of patients with planting double J ureteral，and to explore the effects and applications of the PDCA cycle management on postoperative complications . Methods： 78 cases of patients with operations in our hospital were chosen ，and they were divided into the experimental group and the control group， each group with 39 cases. The control group was given general nursing ，while the experimental group was given the PDCA cycle management.The nursing satisfaction and postoperative complications in the two groups were closed observed and compared. Results： The satisfaction on the mangagment of the experimental group（92.29%）significantly better than the control group （71.79%）postoperative complication rate of Frequent micturition， hematuria， lumbago， sacral discomfort， difficulty in decannulation in the control group was significantly higher than the experimental group， with statistical significance （Plt;0.05）. Conclusions： The PDCA cycle management can decrease the postoperative complication rate of planting double J ureteral ，which is safe and reliable at the same time and can be widely promoted in clinical use.. 　　Keywords：the PDCA cycle management; double J ureteral; postoperative complication 　　输尿管双J管也称输尿管支架管，应用的主要目的是内引流尿液至膀胱，保持肾盂、输尿管、膀胱的通畅，控制感染，防止输尿管梗阻与狭窄，保护肾功能[1]由于输尿管支架管有其良好的内引流和内支撑作用，加上操作简便、定位方便，价格经济等特点，已逐渐成为泌尿外科手术中很重要的辅助器械[2]。但随着应用的推广，给患者带来的负面影响即并发症也不容忽视。在我科双J管主要用于两类患者，一类是恶性肿瘤（如直肠癌、结肠癌、卵巢癌等）所致的输尿管粘连或梗阻;另一类是泌尿科的良性疾病如肾盂输尿管连接处狭窄、泌尿系上尿路结石钬激光碎石术后、输尿管外伤等患者。本研究选择泌尿系结石手术（腔镜经皮肾碎石取石术、输尿管镜钬激光碎石术或开放取石术）后留置输尿管双J管患者作为研究对象，手术后常规安置双J管，留置时间一般为4周