张　宏　童　茜



康复护理对促进宫颈癌根治术患者膀胱功能恢复的影响

张宏童茜

摘要目的：探讨康复护理对促进宫颈癌根治术患者膀胱功能恢复的效果。方法：选择2013年7月～2014年7月我科收治的80例宫颈癌根治术后留置尿管的患者，随机等分为对照组和研究组，对照组给予常规的护理方法，研究组则采用康复护理，主动训练膀胱功能。比较两组患者术后拔除尿管第1次排尿后膀胱功能恢复情况。结果：研究组患者残余尿量少于对照组，膀胱功能恢复优于对照组，差异具有统计学意义(P<0.05)。结论：对宫颈癌根治术患者术前术后早期引入康复护理，主动训练膀胱功能，可加快盆丛神经的恢复并改善手术后膀胱功能，促进术后膀胱功能恢复，减少术后尿潴留的发生。

关键词康复护理； 宫颈癌根治术； 膀胱功能训练

doi:10.3969/j.issn.1672-9676.2016.03.071

Influence of rehabilitation care on promoting bladder function rehabilitation of patients after the radical treatment of cervical cancer

ZHANG Hong,TONG Qian(Tongji Hospital Affiliated Tongji Medical College Huazhong University of Science and Technology，Wuhan430030)

AbstractObjective:To explore the effect of rehabilitation care on promoting bladder function rehabilitation of patients after the radical treatment of cervical cancer.Methods:The 80 cases of patients with placing catheters after the radical treatment of cervical cancer admitted to our department from July 2013 to July 2014 were selected and randomly divided into the control group and the experimental group;the control group was given routine nursing methods while the experimental group was given rehabilitation nursing with active training of bladder function.Recoveries of bladder function of postoperative patients of two groups after the first urination with catheter removed were compared.Results:The residual urine volume of the experimental group was less than that of the control group,and the bladder function recovery of the experimental group was better than that of control group; there was statistical significance of the differences (P<0.05).Conclusion:Rehabilitation nursing introduced in the early period of pre-operation and post-operation and active training of bladder function for patients with the radical treatment of cervical cancer can accelerate the pelvic plexus nerve recovery,improve and promote the postoperative bladder function and reduce the occurrence of the postoperative urinary retention.

Key wordsRehabilitation nursing;Radical hysterectomy;Bladder function training

宫颈癌是发生在宫颈阴道部或移行带的鳞状上皮细胞及宫颈管内膜的柱状上皮细胞交界处的恶性肿瘤，是全球妇女中仅次于乳腺癌常见恶性肿瘤，在我国居妇科恶性肿瘤的首位[1]，严重危害妇女的身心健康。近年来，随着社会生活模式与观念的逐步改变，发病年龄趋于年轻化。得益于对育龄期妇女宫颈细胞学与高危型人乳头瘤状病毒(HPV)筛查的广泛开展，以及阴道镜引导下定点活检等技术的应用，使早期宫颈癌能及时诊断，明显降低了宫颈浸润癌的发病率及死亡率。早期宫颈癌(Ⅰa～Ⅱa期)患者一般以手术治疗为主，需行广泛子宫切除加盆腔淋巴结清扫术，切除范围包括至少3 cm宽的主骶韧带、阴道旁组织及阴道壁。此类手术范围广，对盆腔自主神经破坏较大，因支配膀胱的盆腔自主神经大部分被切断，常出现膀胱感知障碍及收缩功能障碍，从而引起尿潴留，进而引起泌尿系感染及肾后性肾功能不全。……