中藥熱奄包熱敷在老年髖關節置換術后尿潴留的護理效果

[摘要] 目的 研究中藥熱奄包在老年髖關節置換術后尿潴留的應用效果。方法 方便選擇該院2017年6月—2019年6月期間護理的老年髖關節置換術患者112例，由于干預方式不同分為兩組，均56例，其中對照組實施常規護理措施，研究組在此基礎上加用中藥熱奄包處理，觀察兩組患者留置導尿管時間、護理效果總有效率、尿潴留發生率、GQOL-74評分。結果 干預前兩組患者GQOL-74評分情況差異無統計學意義（P>0.05），干預后研究組GQOL-74評分高于對照組，研究組留置導尿管時間優于對照組，研究組護理效果總有效率85.71%高于對照組71.43%，研究組尿潴留發生率7.14%低于對照組17.86%，差異有統計學意義（χ2=6.055、5.253，P<0.05）。結論 對于老年髖關節置換術后尿潴留，可實施中藥熱奄包進行預防護理，可有效降低患者尿潴留發生率，縮短導尿管留置時間，改善患者生活質量，值得應用。

[關鍵詞] 中藥熱奄包;老年;髖關節置換術;尿潴留

[中圖分類號] R473.6? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1674-0742（2020）06（c）-0154-03

Nursing Effect of Traditional Chinese Medicine Hot Pack Hot Compress on Urinary Retention after Hip Replacement

HUANG Liu-ju

Department of External Medicine， Jiexi County People's Hospital， Jieyang， Guangdong Province， 515400 China

[Abstract] Objective To study the effect of Traditional Chinese Medicine Hot Pack on urinary retention after hip replacement in the elderly. Methods 112 elderly patients who underwent hip replacement surgery in the hospital from June 2017 to June 2019 were convenient selected. Due to different intervention methods， 56 patients were divided into two groups， and the control group implemented routine nursing measures. On the other hand， it was treated with traditional Chinese medicine hot pack， and the time of indwelling catheter， total effective rate of nursing effect， incidence of urinary retention and GQOL-74 score were observed in the two groups of patients. Results There was no significant difference in GQOL-74 score between the two groups before the intervention（P>0.05）. After the intervention， the GQOL-74 score in the study group was higher than that in the control group. The retention time of the catheter in the study group was better than that in the control group. The total effective rate was 85.71% higher than the control group 71.43%， and the incidence of urinary retention in the study group was 7.14% lower than the control group 17.86%， the difference was statistically significant （χ2=6.055， 5.253， P<0.05）.Conclusion For the elderly patients with urinary retention after hip replacement， the traditional Chinese medicine hot pack can be implemented for preventive care， which can effectively reduce the incidence of urinary retention in patients， shorten the retention time of catheter， and improve the quality of life of patients.

[Key words] Chinese medicine hot pack; Elderly; Hip replacement; Urinary retention

隨著現代生物技術與手術技術不斷成熟，人工關節置換術成為骨科治療的主要治療手段，由于手術時間較長，手術出血量較大，術后需要常規留置尿管，并配合腰硬聯合麻醉或全身麻醉，使得術后早期拔除尿管后，容易出現尿潴留[1]。尿潴留會使得患者出現膀胱過度膨脹，甚至會出現永久性逼尿肌損傷[2]。出現尿潴留的原因較多，包括排尿方式、心理因素、麻醉藥物等，手術中使得患者排尿中樞受到抑制，需要有效預防術后尿潴留發生，并確保患者治療效果，促進患者康復[3]。拔管后尿潴留會使得患者舒適感降低，再次行留置導尿管會增加泌尿道黏膜損傷，增加尿路感染風險。為了降低患者尿潴留發生率，改善手術效果，該文將中藥熱奄包納入研究，方便選取該院2017年6月—2019年6月112例老年髖關節置換術患者，現報道如下。