经尿道膀胱肿瘤钬激光切除术后膀胱痉挛 危险因素分析及护理对策

Analysis of Risk Factors and Nursing Strategies of Bladder Spasm after Transurethral Holmium Laser Resection of Bladder Tumors

摘要:

〔摘 要〕 目的：分析经尿道膀胱肿瘤钬激光切除术后膀胱痉挛的危险因素，为制定科学合理的护理措施提供依据。 方法：选取 2019 年 3 月至 2021 年 3 月在郑州大学第一附属医院接受经尿道膀胱肿瘤钬激光切除术治疗的 80 例患者 为研究对象，根据术后患者是否发生膀胱痉挛分为痉挛组（31 例）和非痉挛组（49 例），记录两组患者的年龄、姓名、 性别、冲洗液加温情况、尿管气囊注水体积、切除肿瘤体积、低顺应性膀胱或（和）不稳定膀胱情况、前列腺症状评 分（IPSS）、生活质量指数（QOL）评分、焦虑自评量表（SAS）评分等临床资料，开展比较与分析。结果：多因素 logistic 回归分析结果显示，低顺应性膀胱或（和）不稳定膀胱、SAS 评分≥ 50 分、冲洗液没有加温和尿管气囊注水 体积 40 mL 是患者膀胱痉挛的危险因素（P ＜ 0.05）。结论：经尿道膀胱肿瘤钬激光切除术后患者 SAS 评分、尿管 气囊注水体积、冲洗液加温、低顺应性膀胱或（和）不稳定膀胱是其发生膀胱痉挛的危险因素，可基于上述危险因素 制定合理的护理措施，帮助患者更快康复。

Abstract:

〔Abstract〕 Objective To analyze the risk factors of bladder spasm after transurethral holmium laser resection of bladder tumor, and to provide a basis for formulating scientific and reasonable nursing measures. Methods A total of 80 patients who underwent transurethral holmium laser resection of bladder tumors in the First Affiliated Hospital of Zhengzhou University from March 2019 to March 2021 were selected as the research objects. According to whether the patients had bladder spasm after surgery, they were divided into spasm group (31 cases) and non-spasm group (49 cases). The clinical data of the two groups such of patient's age, name, sex, rinses heating condition, urine tube balloon water injection volume, tumor volume, low compliance bladder or (and) unstable bladder, international prostate symptom score (IPSS), the index of quality of life (QOL) score, and self-rating of anxiety scale (SAS) score were compared and analyzed. Results The results of multivariate logistic regression analysis showed that low compliance bladder or (and) unstable bladder, SAS score ≥ 50, no heating of flushing solution and 40 mL water injection volume of catheter balloon were the risk factors for bladder spasm (P < 0.05). Conclusion SAS score, water injection volume of catheter balloon, heating of flushing fluid, low compliance bladder or (and) unstable bladder are the risk factors of bladder spasm in patients with urethral and bladder tumors after holmium laser resection. Reasonable nursing measures can be made based on the above risk factors to help patients recover faster.