Evidence-based nursing for transurethral resection of prostate in elderly patients underwent benign prostatic hyperplasia
-
摘要:目的 探讨基于循证护理(EBN)的强化护理干预在老年良性前列腺增生(BPH)经尿道前列腺电切术(TURP)中的应用价值。方法 将120例因BPH而行TURP的老年患者随机分为对照组与实验组各60例。对照组采取常规护理干预, 实验组在常规护理的基础上，采取基于EBN的强化护理干预，比较2组的护理效果。结果 实验组对BPH及TURP相关知识的掌握显著优于对照组(P < 0.05), 焦虑自评量(SAS)和抑郁自评量(SDS)得分及术后并发症发生率显著低于对照组(P < 0.05); 实验组术后膀胱冲洗时间、导尿管的留置时间及住院时间显著低于对照组(P < 0.05); 实验组治疗效果和护理满意度显著高于对照组(P < 0.05)。结论 基于EBN的强化护理干预在老年BPH的TURP中具有重要价值，有利于降低手术风险，减少术后并发症，改善治疗效果并提高护理满意度。Abstract:Objective To explore the value of strengthening nursing intervention based on evidence-based nursing(EBN) in transurethral resection of prostate(TURP) of elderly patients with benign prostatic hyperplasia (BPH).Methods A total of 120 elderly patients who accepted TURP due to BPH were randomly divided into control group and experimental group, with 60 cases in each group. The control group accepted routine nursing, while the experimental group traditionally accepted strengthened nursing intervention based on EBN. The nursing effect of the two groups was compared.Results Mastery of corresponding knowledge of BPH and TURP of experimental group was better than that of control group(P < 0.05); postoperative Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) scores, and incidence of postoperative complications of experimental group were lower than that of control group(P < 0.05); duration of postoperative bladder irrigation, catheter indwelling time and hospital stay of experimental group were shorter than that of control group(P < 0.05); the effect of treatment and nursing satisfaction of experimental group were higher than that of control group(P < 0.05).Conclusion Strengthened nursing intervention based on EBN is of great value in elderly BPH patients with TURP, it can reduce surgical risk and postoperative complications, improve nursing satisfaction and therapeutic effect.
-
-
表 1 2组焦虑及抑郁自评量表评分比较(x±s)
分 组别 SAS SDS 干预前 术前 术后 干预前 术前 术后 对照组(n= 60) 67.95±5.35 65.42±4.09 61.67±4.75* 62.02±7.96 62.47±6.29 56.15±5.44* 实验组(n= 60) 67.88±5.93 63.52±4.53 59.20±6.02*# 61.98±6.91 59.87±5.40 53.97±5.46*# 与干预前比较, *P < 0.05; 与对照组比较, #P < 0.05。 
下载: 导出CSV
表 2 2组相关知识的掌握情况及其他观察指标比较(x±s)
组别 知识掌握/分 膀胱冲洗时间/h 尿管保留时间/d 住院时间/d 护理干预前 出院前1 d 对照组(n= 60) 64.40±16.59 70.22±10.57* 36.58±3.75 4.97±0.94 7.63±1.28 实验组(n= 60) 64.55±15.86 74.48±9.00*# 34.60±4.59# 4.57±0.79# 7.05±1.29# 与护理干预前比较, *P < 0.05; 与对照组比较, #P < 0.05。
下载: 导出CSV
表 3 2组术中及术后并发症发生率情况[n(%)]
组别 电切综合征 膀胱痉挛 术后出血* 尿道感染 尿失禁 肺部感染 合计 对照组(n= 60) 2(3.33) 12(20.00) 2(3.33) 2(3.33) 3(5.00) 3(5.00) 24(40.00) 实验组(n= 60) 0# 7(11.67) # 1(1.67) # 0# 1(1.67) # 1(1.67) # 10(16.67) # *术后出血量>300 mL; 与对照组比较, #P < 0.05。
下载: 导出CSV
表 4 2组护理满意度比较[n(%)]
组别 不满意 基本满意 较满意 非常满意 整体满意 对照组(n= 60) 7(11.67) 14(23.33) 27(45.00) 12(20.00) 53(88.33) 实验组(n= 60) 1(1.67) 7(11.67) 27(45.00) 25(41.67) 59(98.33)* 与对照组比较, *P < 0.05。
下载: 导出CSV
表 5 2组术后60 d治疗效果比较(x±s)
组别 前列腺症状评分/分 最大尿流率/(mL/s) 术后生活质量评分/分 对照组(n= 60) 11.42±1.63 13.35±2.35 13.67±1.74 实验组(n= 60) 10.82±1.50* 14.30±2.67* 14.35±1.81* 与对照组比较, *P < 0.05。
下载: 导出CSV
-
[1] Alanazi A B, Alshalan A M, Alanazi O A, et al. Epidemiology of senile prostatic enlargement among elderly men in Arar, Kingdom of Saudi Arabia[J]. Electron Physician, 2017, 9(9): 5349-5353. doi: 10.19082/5349
[2] Kosilov K, Kuzina I, Kuznetsov V, et al. Cognitive functions and health-related quality of life in men with benign prostatic hyperplasia and symptoms of overactive bladder when treated with a combination of tamsulosin and solifenacin in a higher dosage[J]. Aging Male, 2017, 11(7): 1-9.
[3] 周婧, 吴慧超. 良性前列腺增生的外科治疗进展[J]. 上海医药, 2017, 38(8): 35-37, 42. https://www.cnki.com.cn/Article/CJFDTOTAL-SYIY201708015.htm [4] 杨华, 贾洪涛, 司敏. 良性前列腺增生的外科治疗进展[J]. 中国老年保健医学, 2017, 15 (3): 61-63. doi: 10.3969/j.issn.1672-4860.2017.03.028 [5] 王媛, 李荣, 申燕琳, 等. 积极心理干预对2型糖尿病患者焦虑抑郁及主观幸福感的影响[J]. 国际护理学杂志, 2016, 35(10): 1368-1371. doi: 10.3760/cma.j.issn.1673-4351.2016.10.026 [6] 蔡芳震, 陈朝虹, 张建育. 三种腔镜前列腺切除手术并发症比较及Clavien-Dindo分级应用[J]. 南方医科大学学报, 2015, 35(9): 1344-1348. doi: 10.3969/j.issn.1673-4254.2015.09.026 [7] Dobrek, Thor P J. Benign prostatic hyperplasia-progress in pathophysiology and management[J]. Pol Merkur Lekarski, 2015, 39(233): 263-270. http://www.ncbi.nlm.nih.gov/pubmed/26637089
[8] Welliver C, Helo S, McVary K T. Technique considerations and complication management in transurethral resection of the prostate and photoselective vaporization of the prostate [J]. Transl Androl Urol, 2017, 6(4): 695-703. doi: 10.21037/tau.2017.07.30
[9] Elsakka A M, Eltatawy H H, Almekaty K H, et al. A prospective randomised controlled study comparing bipolar plasma vaporisation of the prostate to monopolar transurethral resection of the prostate[J]. Arab J Urol, 2016, 14(4): 280-286. doi: 10.1016/j.aju.2016.09.005
[10] 戢艳琼, 龙海燕. 综合心理护理干预对老年住院患者心理状态及生活质量的影响[J]. 实用临床医药杂志, 2016, 20 (8): 147-149. https://www.cnki.com.cn/Article/CJFDTOTAL-XYZL201608049.htm [11] 康立惠, 路慧, 陶娟, 等. 心理护理干预对老年冠状动脉硬化性心脏病介入治疗患者的护理效果观察[J]. 护士进修杂志, 2017, 32(16): 1502-1504. https://www.cnki.com.cn/Article/CJFDTOTAL-FSJX201716023.htm [12] 陈颖, 刘学锋, 蒋朝品. 预见性护理小组的建立对经尿道前列腺电切术疗效及术后并发症的影响[J]. 实用临床医药杂志, 2017, 21(6): 118-121. https://www.cnki.com.cn/Article/CJFDTOTAL-XYZL201706036.htm [13] Hälleberg Nyman M, Forsman H, Ostaszkiewicz J, et al. Urinary incontinence and its management in patients aged 65 and older in orthopaedic care what nursing and rehabilitation staff know and do[J]. J Clin Nurs, 2017, 26(21-22): 3345-3353. doi: 10.1111/jocn.13686
[14] 张理花, 陈娅薇. 以人文关怀为主的优质护理干预在老年重症肺炎患者的应用评价[J]. 护士进修杂志, 2018, 33(5): 419-422. https://www.cnki.com.cn/Article/CJFDTOTAL-FSJX201805011.htm [15] Kang X Q, Xu G, Tian H Y, et al. An analysis of the intervention effect of perioperative evidence-based nursing on orthopedic trauma patients′vagal reflex[J]. Eur Rev Med Pharmacol Sci, 2015, 19(14): 2537-2543. http://smartsearch.nstl.gov.cn/paper_detail.html?id=bf22a2e893e89490010ed33eaad983ed
[16] Mick J. Call to action: How to implement evidence-based nursing practice[J]. Nursing, 2017, 47(4): 36-43. doi: 10.1097/01.NURSE.0000513603.03034.5c
[17] Jueng R N, Huang S H, Li T P, et al. Application of a Q Method Study to Understanding Nurses′Perspective of Adopting Evidence-Based Nursing[J]. Asian Nurs Res: Korean Soc Nurs Sci, 2017, 11(4): 253-260.
[18] Iskakova A M, Abzalova R A, Shalgumbaieva G M, et al. The implementation of new nursing technologies in the Republic of Kazakhstan[J]. Probl Sotsialnoi Gig Zdravookhra -nenniiai Istor Med, 2016, 24(3): 182-185. http://europepmc.org/abstract/MED/29553626
计量
- 文章访问数: 610
- HTML全文浏览量: 363
- PDF下载量: 76
苏公网安备 32100302010246号
