护理干预对下肢骨折患者术后尿潴留的影响(1)
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[摘要] 目的 探讨护理干预对下肢骨折患者术后尿潴留的效果。方法 将60例下肢骨折患者随机分为观察组和对照组，每组30例。两组给予围手术期常规护理，在此基础上观察组实施针对性护理干预，比较两组排尿情况。结果 观察组患者排尿顺利明显高于对照组，差异有统计学意义(P<0.05)，排尿困难和尿潴留例数也明显少于对照组(P<0.05)；两组排尿困难、尿潴留的发生原因排在首位的是麻醉因素，其次是伤口疼痛和导尿管因素。结论 护理干预可以有效降低或避免下肢骨折术后尿潴留的发生，减少患者痛苦，促进术后康复，值得临床推广。
[关键词] 护理干预；下肢骨折；尿潴留
[中图分类号] R473.6 [文献标识码] B [文章编号] 1673-9701(2011)33-95-02
The Influence of Nursing Intervention on Postoperative Urinary Retention in Patients with Fracture of Lower Limb
XIE Haiping
Department of Orthopaedics, Taizhou Central Hospital, Taizhou 318000, China
[Abstract] Objective To explore the effect of nursing intervention on postoperative urinary retention in patients with fracture of lower limb. Methods Sixty cases of lower limb fracture patients were randomly divided into observation group and control group, each of 30 cases. Two groups were given routine nursing during operation period; On the basis of this, the observation group was given the pertinence nursing intervention. Urination situations of two groups were compared. Results Smooth urination of the observation group was obviously higher than the control group, and the difference was statistically significant (P<0.05), dysuria and urinary retention cases were significantly less than control group (P<0.05); The first occurrence cause for two groups’dysuria, urinary retention was anaesthetic factors, followed by wound pain and urinary catheter factors. Conclusion Nursing intervention can effectively reduce or avoid postoperative urinary retention in patients with fracture of lower limb, reduce the suffering of patients, promote postoperative recovery, is worthy of clinical application.
[Key words] Nursing intervention; Lower extremity fracture; Urinary retention
下肢骨折手术常常使用椎管内麻醉，术后容易出现尿潴留[1]。Ringdal等[2]学者研究报道，39%下肢骨折患者术后不能自行小便，尿潴留发生率高达44%。临床上一般采用导尿术解除尿潴留问题，但这样会增加上行感染机会，又给患者带来痛苦和经济负担。近年来，我科采用有效护理干预解除下肢骨折患者术后尿潴留，取得良好的效果，现报道如下。
1 资料与方法
1.1 一般资料
选择2009年3月～2011年3月在我院行下肢骨折手术患者60例，其中男34例，女26例；年龄26～68岁，平均(38.6±8.0)岁；股骨干骨折15例，胫腓骨骨折32例，胫骨骨折7例，股骨粗隆骨折6例。所有患者均知情同意，择期手术，无神经损伤，无尿路感染以及前列腺增生等泌尿系统疾病。随机将60例患者分为观察组和对照组，每组30例，两组患者的性别、年龄、骨折部位以及病情等基本资料差异无统计学意义(P>0.05)，具有可比性。见表1。
1.2 护理方法
对照组采用下肢骨折围术期常规护理，术后排尿困难者采取传统的听流水声、按摩下腹部、会阴冲洗等方法刺激诱导排尿 ......
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