王伟 来光华

[摘要] 目的 觀察综合护理干预在经尿道膀胱肿瘤电切术治疗膀胱肿瘤患者围术期中的应用效果。 方法 选取2015年1月～2017年1月我院收治的膀胱肿瘤患者60例，所有患者术前均行膀胱镜、超声等检查确诊，均行经尿道膀胱肿瘤电切术，采用WOLF 汽化电切镜，以5% 甘露醇为灌洗液，采用腰硬联合麻醉。对照组采取常规护理，干预组采取综合护理，对两组患者干预前后的SAS评分及两组的膀胱冲洗时间、留置导尿管时间、膀胱痉挛发生率、护理满意度进行比较分析。 结果 干预组与对照组患者干预后的SAS评分分别为（32.6±9.1）分、（40.6±11.5）分，干预组的SAS评分显著低于对照组，差异具有显著性（P<0.05）。干预组患者的膀胱冲洗时间、留置导尿管时间明显短于对照组，差异具有显著性（P<0.05）。干预组患者膀胱痉挛发生率明显低于对照组，差异具有显著性（P<0.05）。干预组的护理满意度为96.7%，显著高于对照组，差异具有显著性（P<0.05）。 结论 综合护理干预在经尿道膀胱肿瘤电切术治疗膀胱肿瘤患者围术期中的应用效果较好，可以减轻患者的焦虑心理，有利于术后恢复，且可减少术后并发症的发生率，从而提高护理满意度。

[关键词] 膀胱肿瘤；经尿道膀胱肿瘤电切术；综合护理；SAS

[中图分类号] R473 [文献标识码] B [文章编号] 1673-9701（2018）02-0156-04

[Abstract] Objective To observe the application effect of comprehensive nursing intervention in the patients with bladder tumor treated by transurethral electrocision of bladder tumor during perioperative period. Methods From January 2015 to January 2017， 60 patients with bladder tumor who were admitted to our hospital were selected. All patients were given preoperative cystoscopy and ultrasonography for confirmed diagnosis. All patients were given transurethral electrocision of bladder tumor. WOLF vaporized resectoscope was applied， 5% mannitol was used as lavage fluid， and combined spinal epidural anesthesia was used. The control group was given routine care， and the intervention group was given comprehensive nursing care. The SAS scores， the bladder washing time， indwelling catheter time， incidence of bladder spasm and nursing satisfaction before and after intervention were compared and analyzed between the two groups. Results The SAS scores in the intervention group and control group after intervention were（32.6±9.1） and（40.6±11.5） respectively. SAS scores in the intervention group were significantly lower than those in the control group， and the differences were significant（P<0.05）. The bladder washing time and indwelling catheter time in the intervention group were significantly shorter than those in the control group， and the differences were significant（P<0.05）. The incidence of bladder spasm in the intervention group was significantly lower than that in the control group， and the difference was significant（P<0.05）. The nursing satisfaction in the intervention group was 96.7%， which was significantly higher than that in the control group， and the difference was significant（P<0.05）. Conclusion Comprehensive nursing intervention in transurethral electrocision of bladder tumor in the patients with bladder tumor during the perioperative period has a better application effect， which can reduce the patient's anxiety， is conducive to postoperative recovery， and reduce the incidence of postoperative complications， thereby improving nursing satisfaction.

[Key words] Bladder tumor； Transurethral electrocision of bladder tumor； Comprehensive nursing； SAS

膀胱肿瘤是泌尿外科常见的肿瘤之一，近年来主要采用经尿道膀胱肿瘤电切术治疗。临床实践证实，经尿道膀胱肿瘤电切术具有创伤小、痛苦轻、恢复快等优点[1]。经尿道膀胱肿瘤电切术围术期患者由于对手术过程及效果不了解，多存在焦虑、恐惧、担心等负性心理，导致术后常出现膀胱痉挛、出血、膀胱填塞、泌尿系感染等并发症[2]，因此，在经尿道膀胱肿瘤电切术对围术期采取综合性护理干预对于提高手术治疗效果、降低术后并发症的发生率具有重要作用。本研究旨在探讨综合护理干预在经尿道膀胱肿瘤电切术治疗膀胱肿瘤患者围术期中的应用效果，现报道如下。

1 资料与方法

1.1 一般资料