两种膀胱冲洗方法在全膀胱切除-原位回肠新膀胱术后保持尿管通畅的效果观察(1)
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【摘要】 目的 探讨两种不同膀胱冲洗方法对全膀胱切除-原位回肠新膀胱术后尿管引流效果的影响。方法 收集2006年10月至2009年10月在我科行全膀胱切除-原位回肠新膀胱术患者60例,随机分为A、B两组各30例。A组使用间歇膀胱冲洗法:B组使用手动膀胱冲洗法。两组膀胱冲洗液均使用等渗生理盐水。患者术后均需留置22号FOLEY硅胶三腔导尿管。对两组尿管引流液澄清程度、回肠黏液堵塞尿管等方面的比较。结果 两组患者在尿管引流液澄清程度、尿管堵塞等方面的比较,差异有统计学意义(P<0.01);B组无回肠黏液堵塞尿管,尿管引流液澄清。结论 间歇膀胱冲洗易引起回肠黏液堵塞尿管,手动膀胱冲洗方法,能有效解除回肠黏液引起的尿管堵塞,利于保持尿管引流通畅。
【关键词】 回肠新膀胱; 膀胱冲洗;尿管引流通畅;效果比较
Comparison on Efficacy of Catheter Patency Maintenance with Two Methods of Bladder Irrigation after Radical Cystectomy with Orthotopic Ileal Neoblader
GUAN Jian-yi,MA Xue-xia,LUO Qi-yun.Departmemt of Urology,The Second Affiliated Hospital of Sun Yet-sen University, Guangzhou 510120,China
【Abstract】 Objective To compare the draining efficacy of Foley catheter with two methods of bladder irrigation after radical cystectomy with orthotopic ileal neobladder.Methods From October 2006 to October 2009,60 patients underwent radical cystectomy and orthotopic ileal neobladder in our department were randomly assigned into 2 groups,each with 30 patients.All the patients were catheterized with 22F silicon triple-way Foley catheters and underwent bladder irrigations with normal saline,with intermitten template in Group A and manual template in Group B respectively.Compared the two groups with tubidity of the urine,and the incidence of ileal mucous obstruction.Results The differnce of tubidity of urine and the incidence of catheter obstruction between the two groups were statistically significant(P<0.01).Group B have better tubidity of urine and lower incidence of catheter obstruction.Conclusion Intermitten bladder irrigation relatively increased the incidence of catheter obstruction and bladder spasm.Manual bladder irrigation had better efficacy of catheter patency maintainance by reducing the incidence of catheter obstruction with ileal mucous.
【Key words】Ileal neobladder; Bladder irrigation; Catheter patency; Effect compar
作者单位:510120广州,中山大学附属第二医院泌尿外科
临床上对全膀胱切除-原位回肠新膀胱术后患者行新膀胱冲洗时,常常因为回肠分泌黏液多或陈旧性血块而堵塞尿管。既增加患者痛苦,又增添护士工作量。为观察不同膀胱冲洗方法对保持尿管引流通畅效果的影响,2006年10月至2009年10月,本研究对两种膀胱冲洗方法在保持尿管引流通畅效果上进行比较,以试图寻找安全有效的膀胱冲洗方法,现报告如下 ......
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