摘要
目的通过建立医护协作型原位新膀胱患者综合管理门诊,对患者进行全程管理。方法2018年10月北京大学第一医院建立综合管理门诊;回顾性收集2009年1月至门诊建立前32例患者,门诊建立后至2020年1月14例患者。门诊建立后,采取综合管理模式,包括医护团队执行医患共同决策,指导患者进行盆底肌康复训练,教会家属进行新膀胱冲洗,建立患者档案等;门诊建立前,没有专门人员进行统一管理,由医生进行新膀胱冲洗等。结果46例原位新膀胱患者的日间和夜间完全控尿率分别为82.6%(38/46)和71.7%(33/46)。门诊建立后,患者的日间和夜间完全控尿率分别为12/14和9/14。门诊建立后患者的住院时间及进食时间分别为(13.36±9.44)、(5.00±2.11)d,均少于门诊建立前的(17.28±9.98)、(5.78±2.90)d,但两者之间差异无统计学意义(t值为-1.247、-0.905,均P>0.05)。但关于日间和夜间控尿情况,大于1片尿不湿的例数占比,门诊建立后明显好于建立前。结论综合管理门诊的建立满足了原位新膀胱患者的需求,使患者尽快获得控尿及排尿能力,有利于改善患者的临床结局。
Objective To build a comprehensive clinical management of outpatient with orthotopic neobladder based on doctor-nurse cooperation to provide overall service to patients.Methods The comprehensive clinical management was established in October 2018,32 patients were collected retrospectively from January 2009 to before the establishment of the clinic,and 14 patients were collected from the establishment of the clinic to January 2020.After the establishment of the clinic,the comprehensive management mode was adopted,including the medical team implementing management from the aspects of implementing doctor-patient joint decision-making,guiding patients to carry out pelvic floor muscle rehabilitation training,teaching family members to carry out new bladder irrigation,and establishing patients′records.Before the establishment of the clinic,there was no specialized personnel for unified management,and the doctor for new bladder irrigation and so on.Results The rate of complete urinary control in the 46 patients with orthotopic neobladder was 82.6%(38/46)in the day and 71.7%(33/46)in the night.The rates of complete urine control of patients in the day and night were 12/14 and 9/14 after the establishment of the clinic.The length of stay which was(13.36±9.44)d,and feeding time which was(5.00±2.11)d of the patients after the establishment of the clinic were both less than those of the patients before the establishment of the clinic,which were(17.28±9.98)d and(5.78±2.90)d,but the differences were not statistically significant(t values were-1.247 and-0.905 respectively,bothP>0.05).However,for diurnal and night-time urine control,the proportion of people with more than one diaper was better after the establishment of outpatient clinic than before.Conclusions The establishment of the comprehensive clinical management meets the needs of patients with orthotopic neobladder,enables patients to get the function of continence and urination sooner,and contributes to improve the clinical outcome of patients.
作者
于书慧
丁光璞
李学松
黄燕波
郝瀚
Yu Shuhui;Ding Guangpu;Li Xuesong;Huang Yanbo;Hao Han(Urology Department,Peking University First Hospital,Beijing 100034,China;Department of Urology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)
出处
《中国实用护理杂志》
2021年第36期2848-2852,共5页
Chinese Journal of Practical Nursing
关键词
原位新膀胱术
医护协作
综合管理门诊
建立
管理
Orthotopic neobladder
Doctor-nurse cooperation
Comprehensive outpatient service
Establishment
Management
