张宏,卢吉,吕英瑛,等.出院准备计划在宫颈癌术后患者膀胱功能康复中的应用[J].中华物理医学与康复杂志,2026,48(1):50-55
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| 出院准备计划在宫颈癌术后患者膀胱功能康复中的应用 |
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| DOI：10.3760/cma.j.cn421666-20250814-00692 |
| 中文关键词: 出院准备计划 宫颈癌术后 尿潴留 膀胱功能康复 |
| 英文关键词: Discharge planning Radical hysterectomy Urinary retention Bladder function rehabilitation |
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| 中文摘要: |
| 目的 探讨出院准备计划在宫颈癌术后患者膀胱功能康复中的应用效果，并评价其对膀胱功能恢复、泌尿系感染发生率、患者依从性、生活质量和满意度的影响。 方法 采用便利抽样法，选取某三级甲等医院妇科肿瘤2个病区接受非保留神经的广泛性子宫切除和盆腔淋巴结清扫术的宫颈癌患者125例，将一病区63例患者设为对照组，二病区62例患者设为观察组。2组患者入院后均接受疾病宣教和术后康复指导，在此基础上对照组实施常规膀胱功能康复，包括盆底肌肉锻炼、排尿日记和定时排尿训练等；观察组则实施DP，包括入院评估、住院期间康复训练、出院前准备、出院指导和随访等。比较2组患者出院当天的残余尿量合格率和生活质量，以及出院后第30天的泌尿系感染发生率、间歇导尿依从性和满意度、盆底肌肉锻炼依从性和自我效能、生活质量，并进行统计学分析。 结果 观察组出院当天的残余尿量合格率（χ2=4.232）和出院后第30天的泌尿系感染发生率（χ2=5.494）、间歇导尿依从性（χ2=25.637）、间歇导尿满意度（Z=2.25）、盆底肌肉锻炼依从性（t=2.837）、盆底肌肉肉锻炼自我效能（t=15.334）以及生活质量（t=-7.208）均显著优于对照组，差异均有统计学意义（P<0.05）。 结论 出院准备计划的应用可显著改善宫颈癌术后患者膀胱功能，不仅可以提升患者残余尿量的合格率，降低其泌尿系感染的发生率，还可提高患者的依从性、满意度和生活质量。 |
| 英文摘要: |
| Objective To investigate the effects of a discharge planning (DP) program on postoperative bladder function recovery in patients with cervical cancer. Methods A total of 125 patients with cervical cancer who underwent non-nerve-sparing radical hysterectomy combined with pelvic lymph node dissection were recruited from two gynecologic oncology wards of a tertiary hospital, by using the convenience sampling method. Patients in one ward (n=63) were assigned to the control group，and those in another ward (n=62) to the intervention group. Both groups received routine education on the disease and postoperative rehabilitation. The control group received conventional bladder function rehabilitation interventions including pelvic floor muscle exercises (PFME), scheduled voiding training and voiding diaries. The intervention group was administered with a discharge planning program, including admission assessment, inpatient rehabilitation training, pre-discharge preparation, discharge instructions and follow-up, in addition to routine care. Outcomes were compared between the two groups in terms of the rate of satisfactory pos-tvoid residual (PVR) volume and quality of life (QOL) on the day of discharge, as well as the incidence of urinary tract infection (UTI), compliance to and satisfaction with intermittent catheterization, compliance to and self-efficacy of PFME, and QOL on a follow-up after 30 days of discharge. Results Compared with the control group, the intervention group demonstrated a significantly higher rate of satisfactory PVR volume on the day of discharge (χ2=4.232), lower incidence of UTI (χ2=5.494), higher compliance to IC (χ2=25.637), greater satisfaction with IC (Z=2.25), higher compliance to PEME (t=2.837), higher PFME self-efficacy (t=15.334), and better QOL (t=-7.208) after 30 days of discharge. All differences were statistically significant (P<0.05). Conclusions The implementation of a discharge planning program significantly improves postoperative bladder function recovery in patients with cervical cancer. It increases the rate of satisfactory PVR volume，reduces the incidence of UTI，and improves patient compliance, satisfaction and QOL. |
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