護理干預對經尿道前列腺電切術后認知功能的影響及療效觀察

朱巧愛　張忠　蔣聿瑛等

[摘要] 目的 探討護理干預對經尿道前列腺電切術（TURP）后認知功能影響及療效觀察。 方法 72例TURP患者隨機分為觀察組和對照組。對照組予以圍手術期常規護理，觀察組予以綜合性護理干預。 結果 術后1d兩組MMSE和HDS評分均明顯下降（P < 0.05），觀察組下降值少于對照組（P < 0.05）。術后3 d觀察組MMSE和HDS評分恢復術前水平（P > 0.05），而對照組仍低于術前水平（P < 0.05）。隨訪3個月，觀察組術后總有效率明顯優于對照組（χ2=4.18，P < 0.05）。 結論 綜合性護理干預可減少TURP術后認知功能下降幅度，并能改善下尿路梗阻癥狀，提高術后療效，有利于患者康復。

[關鍵詞] 經尿道前列腺電切術；綜合性護理；認知功能

[中圖分類號] R473.6 [文獻標識碼] B [文章編號] 1673-9701（2014）11-0082-03

[Abstract] Objective To discuss influence and curative effect observation of nursing intervention on cognitive function after transurethral resection of prostate（TURP）. Methods Seventy-two cases of patients with TURP were divided into observation group and control group at random. The patients in control group were given routine nursing in perioperative period. The patients in observation group were additionally given comprehensive nursing intervention. Results The MMSE and HDS scores of patients in two groups one day after the operation obviously were declined（P < 0.05）， and the declining rate in observation group was lower than that in control group（P < 0.05）. The MMSE and HDS scores of patients in observation 3 days before the operation were return to the same levels as those before the operation（P > 0.05）， while the MMSE and HDS scores of patients in control group were still obviously lower than those before the operation （P < 0.05）. According to 3 months following-up after the operation， the total clinical efficiency of patients in observation group after the operation was much higher than that in control group（χ2=4.18， P < 0.05）. Conclusion The comprehensive nursing intervention can reduce the occurrence rate thereof operated on TURP， obviously improve the symptoms of lower urinary tract obstruction， enhance the curative effect after the operation， and is in favor of the recovery of patients.

[Key words] Transurethral resection of prostate （TURP）； Comprehensive nursing； Cognitive function

經尿道前列腺電切術（TURP）是治療良性前列腺增生（BPH）最常用的手術方式，術后認知功能下降是TURP術后常見的并發癥，主要是由于BPH年齡較大，心理承受能力下降，術后易發生認知功能下降[1]。這不但會影響患者治療依從性，而且會增加患者術后并發癥的幾率，影響術后療效[2]。近年來研究發現護理干預對TURP術后認知障礙下降具有較好的改善作用，并能提高手術療效[3]。本研究觀察了綜合性護理干預對TURP術后認知障礙的影響及療效，現報道如下。

1 資料與方法

1.1 一般資料

選擇2012年7月～2013年6月在我院住院行TURP手術治療的BPH患者72例。納入標準：具有尿頻、進行性排尿困難等典型癥狀，且PSA檢查正常，尿動力學檢查示膀胱出口梗阻。排除標準：尿道狹窄、神經源性膀胱、前列腺癌和膀胱頸纖維化患者。采用隨機數字表將患者分為觀察組和對照組各36例。兩組患者在年齡構成、病程、最大尿流率（Qmax）及伴隨疾病等方面比較差異無統計學意義（P > 0.05），具有可比性。見表1。

1.2 治療方法

對照組患者予以TURP圍手術期常規護理，包括術前準備、術后生命體征觀察、飲食護理和留置尿管護理等。觀……