Zheng Xi-Chun, Luo Ting-Ting, Cao Dan-Dan, Cai Wen-Zhi
Department of Urology, Shenzhen Hospital of Southern Medical University, Shenzhen 518000, Guangdong Province, China.
Nursing Department, Southern Medical University, Shenzhen 518000, Guangdong Province, China.
World J Clin Cases. 2022 Feb 16;10(5):1517-1526. doi: 10.12998/wjcc.v10.i5.1517.
Patients with benign prostatic disease often experience detrusor morphological changes and dysfunction. In severe cases, it leads to bladder detrusor dysfunction, resulting in dysuria, frequent urination, urgent urination, incomplete urination, and other symptoms including renal function injury. An operation to restore normal urination function and to control postoperative complications, as far as possible, is the most common method for benign prostatic disease.
To observe the effect of precise nursing service mode on postoperative urinary incontinence prevention in patients with prostate disease.
In total, 130 patients diagnosed with benign prostatic disease, from January 2018 to June 2021, in our hospital, were selected and divided into observation and control groups according to their treatment options. Sixty-five cases in the control group were given routine nursing mode intervention and 65 cases in the observation group received precise nursing service mode intervention. The intervention with the observation group included psychological counseling about negative emotions, pelvic floor exercises, and post-hospital discharge care. The complications of the two groups were counted, and the general postoperative conditions of the two groups were recorded. The urinary flow dynamics indexes of the two groups were detected, and differences in clinical international prostate system score (IPSS) and urinary incontinence quality of life questionnaire (I-QOL) scores were evaluated.
Postoperative exhaust time (18.65 ± 3.23 h and 24.63 ± 4.51 h), the time of indwelling catheter (4.85 ± 1.08 d and 5.63 ± 1.24 d), and hospitalization time (8.78 ± 2.03 d and 10.23 ± 2.28 d) in the observation group were lower than in the control group. The difference was statistically significant ( < 0.05). After the operation, the maximum urinary flow rate (Qmax) increased ( < 0.05), the residual urine volume (RUV) decreased ( < 0.05), and the maximum closed urethral pressure (MUCP) was not statistically significant ( > 0.05) compared to pre-operation. The Qmax of the observation group was higher than that of the control group, while the RUV was lower than that of the control group. There was no significant difference in MUCP between the observation and control groups ( > 0.05). The I-QOL score of the two groups improved ( < 0.05), and the IPSS decreased ( < 0.05). After the operation, the I-QOL score of the observation group was higher than that of the control group, and the IPSS was lower than that of the control group ( < 0.05). There were no significant differences in the incidence of urethral injury (1.54% and 3.08%), bladder spasm (0.00% and 1.54%), and secondary bleeding (1.54% and 4.62) between the observation and control groups ( > 0.05).
The precise nursing service mode can reduce the incidence of postoperative urinary incontinence in patients with prostate disease, thus improving postoperative urodynamics and rehabilitation, and quality of life.
良性前列腺疾病患者常出现逼尿肌形态改变和功能障碍。严重时，会导致膀胱逼尿肌功能障碍，引发排尿困难、尿频、尿急、排尿不尽等症状，甚至包括肾功能损害。进行手术以恢复正常排尿功能并尽可能控制术后并发症，是治疗良性前列腺疾病最常用的方法。
观察精准护理服务模式对前列腺疾病患者术后预防尿失禁的效果。
选取2018年1月至2021年6月在我院诊断为良性前列腺疾病的130例患者，根据治疗方案分为观察组和对照组。对照组65例采用常规护理模式干预，观察组65例采用精准护理服务模式干预。观察组的干预措施包括针对负面情绪的心理咨询、盆底肌锻炼及出院后护理。统计两组的并发症情况，记录两组患者术后的一般状况。检测两组的尿流动力学指标，评估临床国际前列腺症状评分（IPSS）和尿失禁生活质量问卷（I-QOL）评分的差异。
观察组术后排气时间（18.65±3.23小时和24.63±4.51小时）、留置导尿管时间（4.85±1.08天和5.63±1.24天）及住院时间（8.78±2.03天和10.23±2.28天）均低于对照组。差异具有统计学意义（P<0.05）。术后，与术前相比，最大尿流率（Qmax）升高（P<0.05），残余尿量（RUV）减少（P<0.05），最大尿道闭合压（MUCP）差异无统计学意义（P>0.05）。观察组的Qmax高于对照组，而RUV低于对照组。观察组与对照组的MUCP差异无统计学意义（P>0.05）。两组的I-QOL评分均改善（P<0.05），IPSS降低（P<0.05）。术后，观察组的I-QOL评分高于对照组，IPSS低于对照组（P<0.05）。观察组与对照组在尿道损伤发生率（1.54%和3.08%）、膀胱痉挛发生率（0.00%和1.54%）及继发性出血发生率（1.54%和4.62%）方面差异无统计学意义（P>0.05）。
精准护理服务模式可降低前列腺疾病患者术后尿失禁的发生率，从而改善术后尿动力学及康复情况和生活质量。
