| ObjectiveClinical nursing pathway(CNP)was developed to prevent urinary retention after radical cervical cancer resection,and adopted to patients who with early radical cervical cancer resection.This paper is to compare the spontaneous urination,residual urine volume,incidence of urinary retention,and urinary tract irritation in CNP group and normal clinical nursing group,and to explore the effect of CNP on preventing urinary retention after radical cervical cancer resection.MethodsThis research was a quasi-experimental study,and two different nursing models were taken to intervene in patients undergoing radical surgery for cervical cancer.Cervical cancer patients in a grade 3A hospital in Yantai City diagnosed with Ia2-IIa1 FIGO stage were selected.On the day of the scheduled hospitalization,according to the sampling principle of the whole group,the patients in No.1 ward who met the admission criteria were set up as the intervention group,and the patients who met the inclusion criteria in No.2 ward area were set as the control group.After excluding patients with mutation and withdrawal,finally,117 patients were enrolled,59 in the intervention group and 58 in the control group.The control group received routine perioperative nursing measures:from admission to discharge,sequential admission to hospital care,preoperative care,postoperative care,and discharge care,including inpatient environment introduction,examination,laboratory guidance,diet,activity guidance,and indwelling catheterization nursing;the intervention group implemented the CNP method on the basis of routine nursing.The bladder function training was started from the scheduled hospitalization day.After admission,the hospitalization time was divided into 6 periods:the first day,2th-4th day(the day before surgery),3th-5th day(surgery day),4th-6th day(1st day after surgery),5th-14th days of hospitalization(2-10 days after surgery),and the 15th to 20th day(discharge day),the medical order implementation,nursing evaluation,general nursing,prevention of urinary retention care(bladder function exercise,acupuncture point pressing,sterile intermittent catheterization)were filled into the clinical care pathway table and the variation would be recorded.When the patients were discharged from the hospital,the spontaneous urination,residual urine volume,urinary retention rate,and urinary tract irritation were compared between the two groups.On the premise of ensuring the accuracy and integrity of all data,SPSS 19.0 was used,and t test,chi-square test,variance analysis was employed to analyze difference among groups.P<0.05 was regard as statistically significant.Results1.There was no significant difference in age,education level,pathological type,tumor stage,operation time and number of days of removal of catheter for the first time between the intervention group and the control group(P>0.05).2.After removal of the urethra,urinate spontaneously in the intervention group was56patients(94.9%),and that in control group was 48 patients(82.7%).?~2=4.376,P<0.05,and there was statistical difference between the two groups.The number of patients with spontaneous urination in the intervention group was significantly higher than that in the control group.3.The average PVR of the intervention group was 49.68±9.42ml ml after extubation,and the average PVR of the control group was 82.30±14.16 ml.t=3.206,P<0.05,there was significant difference in PVR between the two groups.PVR of the intervention group was significantly smaller than the control group.4.There were 9 cases of urine retention in the intervention group,the incidence rate was 15.3%;in the control group,24 patients had an incidence of urinary retention of41.4%.?~2=9.858,P=0.02<0.05,the incidence of urinary retention in the intervention group was significantly lower than that in the control group.5.In the intervention group,58 patients had no urinary tract irritation,1 had urinary tract irritation,and the incidence of urinary tract irritation was 1.7%.In the control group,52 patients had no urinary tract irritation,and 6 had urinary tract irritation.The incidence rate was 10.3%.?~2=3.890,P=0.039<0.05,the urinary tract irritation in the intervention group was lower than that in the control group,and there was statistical difference between the two groups.Conclusion1.The application of CNP promoted the recovery of bladder spontaneous urination function and reduced residual urine volume,incidence of urinary retention,rurinary tract irritation.It has a good effect on preventing the occurrence of urinary retention in patients with early cervical cancer.2.CNP model is suitable for the prevention of urinary retention in patients with early cervical cancer after surgery. |
PDF Full Text Request