Clinical Observation On Prevention Of Postoperative Urinary Retention In Elderly Patients With Hip Fracture By Transcutaneous Electrical Acupoint Stimulation

ObjectiveThis study is devoted to evaluate the effect of transcutaneous electrical acupoint stimulation on postoperative urination,and to clarify the effectiveness and safety of transcutaneous electrical acupoint stimulation to prevent postoperative urinary retention(POUR)in elderly patients with hip fractures,which is to seek a safe,effective,and easy-to-implement intervention of integrating traditional Chinese and western medicine for the prevention of POUR in orthopedics.MethodsThe study selected 70 patients from February 2019 to December 2019 in our hospital's trauma orthopedics ward who met the inclusion and exclusion criteria,and were randomly divided into observation group and control group,with 35 cases in each group.The control group was given routine nursing prevention including psychological intervention,preoperative urination training,diet adjustment and pain care,and the observation group added transcutaneous electrical acupoint stimulation intervention on this basis.The differences in the incidence of POUR,the condition of first postoperative urination,average urine flow rate(AUFR),bladder residual urine(BRU),and the Longbi severity rating score(LSRS)were compared between the two groups.ResultsIn this study,a total of 67 cases with effective statistical data were obtained,including 33 cases in the observation group and 34 cases in the control group.There was no statistically significant difference in age,gender,body mass index,fracture site,preoperative preparation time,and operation time between the two groups(P>0.05),which were comparable.1.The incidence of POUR: POUR occurred in 3 patients in the observation group and 11 patients in the control group.The incidence of POUR in the observation group was 9.09%,which was lower than 32.35% in the control group,the difference was statistically significant(P<0.05).2.The condition of first postoperative urination: The condition of first postoperative urination includes 4 indicators,namely the first urination time,the first urination waiting time,the first urination duration and the first urination volume.There was no significant difference in the first urination time and the first urination duration between the two groups(P>0.05);however,There was significant difference in the first urination waiting time and the first urination volume between the two groups(P<0.05),the first urination volume of the observation group was significantly higher than that of the control group,and the first urination waiting time was significantly lower than that of the control group.3.The AUFR: The highest AUFR was 18.22ml/s in the observation group,with 13 cases greater than 15ml/s.The highest AUFR was 17.21ml/s in the control group,with 5 cases greater than 15ml/s.The difference in AUFR between the two groups was statistically significant(P<0.05).The AUFR in the observation group was significantly higher than that in the control group.4.The BRU: The maximum volume of the BRU was 500 ml in the observation group,with 20 cases less than 10 ml.The maximum volume of the BRU was 600 ml in the control group,with 13 cases less than 10 ml.The difference of BRU between the two groups was statistically significant(P<0.05).The BRU in the observation group was significantly less than that in the control group.5.The LSRS: The score includes five aspects.Except that the difference in the scores of lower abdominal symptoms is not statistically significant(P>0.05),the difference in the scores of the other 4 symptoms and signs are statistically significant(P<0.05),the observation group is better than the control group.The total score between the two groups was significantly different(P<0.05).The observation group had 29 mild cases,2 moderate cases,and 2 severe cases;the control group had 22 mild cases,2 moderate cases,and 10 severe cases.The total score of the observation group was significantly better than that of the control group.ConclusionTranscutaneous electrical acupoint stimulation combined with routine nursing measures can improve the first postoperative urination and improve the efficiency of postoperative urination,which is conducive to the recovery of postoperative bladder function and can better prevent postoperative urinary retention in elderly hip fracture patients.This preventive measure is safe and reliable,easy to operate,economical and practical.