| Objective : This study focused on the comfort of patients and the establishment of spontaneous urination reflex after extubation.The four-step method of "injection-release-injection-drink" was used to extubate the tube,aiming to increase the patient’s extubation comfort and make the patient remove urine.The spontaneous urination reflex is established early after the tube to reduce the occurrence of problems related to extubation.Provide a basis for the method of indwelling urinary catheter extubation after fracture,and provide a reference for the formulation of industry standards for this nursing operation.Methods: This study is a randomized controlled trial,after the international prostatic symptom score(IPSS)was used for case screening,200 hospitalized patients who met the inclusion criteria for trauma and orthopedic surgery with indwelling catheters were randomly divided into a test group and a control group with 100 cases each.For 100 patients in the control group,after the doctor’s order was issued,the tube was extubated when the bladder was full,and the patient was instructed to urinate after the extubation.The patient was verbally instructed to drink 500-1000 ml of water without supervision;100 patients in the test group were treated with "injection-release-brew-drink" "The four-step method for extubation,after the doctor’s order,when the patient’s bladder is filled,drain the fluid in the airbag at the front of the catheter,and reinject 0.3-0.5ml of air(Note),and then open the catheter regulator to drain 200 ml of urine(Extubation),with the help of the patient’s voluntary excretion of urine(flushing),homeopathic extubation.After extubation,urge the patient to drink500-1000ml(drink)within 30 minutes(ignoring the amount of fluid input,considering that there is little difference in the amount of fluid input between the two groups of patients),and observe the occurrence of problems related to the extubation of the two groups and the first urine output after extubation And the waiting time for urination,and the construction of spontaneous urination reflex after extubation.Results:1.The occurrence of problems related to extubation of the two groups of study subjects:extubation discomfort,urination pain,and urinary hesitation are common,especially extubation discomfort and urination pain are prominent,and urinary retention is rare;the extubation method of the experimental group is reducing extubation The effect of related problems is better than that of the control group.2.Spontaneous urination rate: 95 of the 98 patients in the control group urinate smoothly after extubation,and the spontaneous urination rate is 96.93%;98 patients in the experimental group all urinate smoothly after extubation.The comparison of voluntary urination after extubation between the two groups of study subjects showed no significant difference after analysis(P>0.05).3.Extubation comfort: In the control group,16 cases(16.33%)had no discomfort after extubation,and the discomfort was mainly 2 degrees(43.88%);34 cases(34.69%)in the test group had no discomfort after extubation,The degree of discomfort was mainly 1 degree(34.69%).There was a statistically significant difference in extubation comfort between the two groups of subjects(P<0.05).4.Incidence rate of urinary hesitation symptoms: 25 patients(25.51%)in the control group had urinary hesitation symptoms after extubation;13 patients(13.27%)in the experimental group had urinary hesitation symptoms after extubation.There was a statistically significant difference in the occurrence of urinary hesitation after extubation between the two groups of subjects(P<0.05).5.Urination pain: The incidence of urination pain in the control group was higher than that in the test group.The degree of urination pain in the control group was 2 degrees(32.65%).The urination pain in the test group was mainly 1 degree(35.71%).The difference in urination pain between the two groups was statistically significant(P<0.05).6.Incidence rate of urinary retention: There was no urinary retention in the test group after extubation,and 3 patients in the control group had urinary retention after extubation.There was no statistically significant difference in the incidence of urinary retention after extubation between the two groups of subjects(P>0.05).7.Waiting time for first urination after extubation: The average waiting time for urination after extubation in the control group was 248.62±37.70 min,and the average waiting time for urination after extubation in the test group was 184.59±32.74 min.The difference in waiting time for the first urination after extubation between the two groups was statistically significant(P<0.05).8.First urinary volume after extubation: The average urinary volume of the control group after extubation was 340.26±46.11 ml,and the average urinary volume of the test group after extubation was 377.96±53.53 ml.The difference of the first urine output after extubation between the two groups was statistically significant(P<0.05).Conclusions: Extubation related problems in patients with indwelling catheter after fracture are more common,especially the discomfort of extubation and painful urination.The four-step extubation method of "inject-release-cush-drink" in the experimental group can reduce the incidence of urinary hesitation and reduce the incidence of extubation discomfort compared with the control group simply in the bladder filling and extubation method.It can reduce the rate and degree of urination pain;it can shorten the waiting time for the first urination after extubation,increase the amount of urination,and is beneficial to the construction of urination reflex and the recovery of bladder function after extubation. |
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