21例子宫膀胱全切原位乙状结肠代膀胱患者膀胱功能训练的护理

摘要

Objective To discuss the urinary training in patients with radical uterus-cystectomy plus orthotopic ileal neobladder. Methods Twenty-one female patients with bladder cancer received radical uterus-cystectomy plus orthotopic ileal neobladder surgery from March 2007 to August 2011. The patients were received urinary function training after operation. Results At three months after operation, 17 patients had formed automatic urinary function and urinated 250~400ml per time 5~9 times per day. Three patients suffered from mild urinary incontinence during sleep. One patient had long-term uninary incontinence and died due to severe pneumonia 10 months after operation. Conclusion Proper nursing is important to promote the formation of urinary function in patients with orthotopic ileal neobladder.%目的 探讨子宫、膀胱全切原位乙状结肠代膀胱术后膀胱功能训练的护理.方法 2007年3月至2011年8月共收治患有膀胱癌并行子宫、膀胱全切原位乙状结肠代膀胱手术的女性患者21例,术后对患者进行储尿功能、尿意、控尿和排尿功能训练.结果 术后3个月17例能良好控制排尿,每日排尿5～9次,每次250～400ml.3例夜间有轻度尿失禁现象,通过控制睡前2h饮水及每隔4h闹钟叫醒排尿后症状逐渐好转.1例长期尿失禁,术后10个月时因重度肺炎死亡.结论 按照训练计划坚持全面的膀胱功能训练是原位乙状结肠代膀胱术后形成满意控尿和排尿功能的关键.