Total diz ve kalça protezi ameliyatı geçiren hastalarda kalıcı üriner kateteri çıkarmadan önce klemplemenin idrar miktarına ve miksiyon süresine etkisi

Amaç: Bu araştırma, total diz ve kalça protezi ameliyatı geçiren hastalarda kalıcı üriner kateteri çıkarmadan önce kateteri klemplemenin idrar miktarı ve miksiyon süresine etkisini incelemek amacıyla yapılmıştır. Gereç ve Yöntem: Örneklemi total diz ve kalça protezi ameliyatı geçiren 60 hasta oluşturmuştur. Yaş grubu ve cinsiyete göre randomize edilerek hastalar çalışma kapsamına alınmıştır. Deney grubundaki hastalarda kalıcı üriner kateteri çıkarma istemi verildikten sonra, idrarın mesanede birikmesi için hastaların kalıcı üriner kateteri 3 saat süreyle üst üste iki kez klemplenmiştir ve her 3 saatin sonunda klemp açılarak 5 dakika süreyle idrarın akması sağlanmıştır. Kontrol grubundaki hastalarda ise klempleme yapılmaksızın kateter çıkarılmıştır. Kateter çıkarıldıktan sonra ilk idrar yapmada çıkan idrar miktarı ölçülmüş olup ilk miksiyon süresi dakika olarak hesaplanmıştır. Bulgular: Üriner kateter çıkarıldıktan sonra deney ve kontrol grubundaki hastaların ortalama idrar miktarı sırasıyla 293.50±239.53 ml, 204.00±195.25 ml’dir. Deney ve kontrol grubundaki hastaların ortalama miksiyon süresi sırasıyla 214.63±185.72 dk, 211.16±192.77 dk’dır. Kalıcı üriner kateteri çıkarmadan önce klemplemenin idrar miktarını ve miksiyon süresini etkilemediği saptanmıştır. Sonuç: Bu araştırma sonuçları, total diz ve kalça protezi ameliyatı geçiren hastalarda kalıcı üriner kateter çıkarılmadan önce kateteri klemplemenin idrar miktarına ve miksiyon süresine etkisinin olmadığını göstermiştir.

Anahtar Kelimeler:

Klempleme, üriner kateterizasyon, hemşirelik

Effects of clamping on micturition time and amount of urine before removing indwelling urinary catheters in patients who underwent total knee and hip arthroplasty

Purpose: This research was carried out to examine the effect of clamping on amount of urine and micturation time before removing indwelling urinary catheters in patients who underwent total knee and hip arthroplasty. Materials and Methods: The sample consisted of 60 patients who underwent total knee and hip arthroplasty. Patients were randomized according to the age group and gender were included in the study. After receiving request to removal the indwelling urinary catheters in patients in the experimental group, the patient’s indwelling urinary catheter was clamped twice for 3 hours for urine to accumulate in the bladder and clamping was performed at each clamping interval and urine flow was provided for 5 minutes. In the control groups patients, the catheter was removed without clamping. After removal of the catheter, the amount of urine in the first urine was measured and the first micturation time was calculated as minutes Results: After removal of the urinary catheter, the experimental and control groups had a mean amount of urine of 293.50±239.53 ml and 204.00±195.25 ml, respectively. The experimental and control groups had a mean micturition time of 214.63±185.72 min and 211.16±192.77 min, respectively. The clamping does not affected the amount of urine and the micturation time before the indwelling urinary catheter was removed. Conclusion: Clamping indwelling urinary catheters before removing them had no effect on amount of urine and micturition time among patients who underwent total knee and hip arthroplasty.

Keywords:

Clamping, urinary catheterization, nursing,

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1. Griesdale DEG, Neufeld J, Dhillon D, Joo J, Sandhu S, Swinton F, et. al. Risk factors for urinary retention after hip or knee replacement: a cohort study. Can J Anaesth. 2011;58:1097-1104.
2. Markopoulos G, Kitridis D, Tsikopoulos K, Georgiannos D, Bisbinas I. Bladder training prior to urinary catheter removal in total joint arthroplasty. A randomized controlled trial. Int J Nurs Stud. 2019;89:14-7.
3. Agrawal K, Majhi S, Garg R. Post-operative urinary retention: review of literature. World J Anesthesiol. 2019;8:1-12.
4. Gong Y, Zhao L, Wang L, Wang F. The effect of clamping the indwelling urinary catheter before removal in cervical cancer patients after radical hysterectomy. J Clin Nurs. 2016;26:1131-36.
5. Liu Y, Wei S, Elliott M. The effects of a catheter clamping protocol on bladder function in neurosurgical patients: a controlled trial. Int J Nurs Pract. 2015;21:29-36.
6. Joanna Briggs Institute. Removal of short-term indwelling uretral catheters. Nurs Stand. 2008;22:42- 5.
7. Balcı Akpınar R. Üriner boşaltım. Hemşirelik esasları hemşirelik bilimi ve sanatı (Ed. A Atabek & A Karadağ):974-1000. İstanbul, Akademi Basın ve Yayıncılık, 2014.
8. Nazarko L. Effective evidence-based catheter management: an update. Br J Nurs. 2010;19:948-53.
9. Yılmaz F, Özden D. Hemşirelerin kalıcı üriner kateterizasyonda mesane jimnastiğine ilişkin uygulama ve görüşleri. Hemşirelikte Araştırma ve Geliştirme Dergisi 2019;21:55-68.
10. Craven RF, Hirnle C, Jensen S. Hemşirelik esasları: İnsan sağlığı ve fonksiyonları (Çev. Ed. N Uysal & E Çakırcalı):1013-1068. 7. Baskı. Ankara, Palme Yayıncılık, 2015.
11. Süzen B, Sarı D. Üriner sistem ve uygulamaları. Sağlık uygulamalarında temel kavramlar ve beceriler (Ed. F Akça Ay): 606-636. 4.baskı. İstanbul, Nobel Tıp Kitabevleri, 2012.
12. Nyman M, Johansson J, Gustafsson M. A randomised controlled trial on the effect of clamping the indwelling urinary catheter in patients with hip fracture. J Clin Nurs. 2010;19:405-13.
13. Kanza Gül D. Effects of urinary catheter clamping after cesarean section on urinary retention and urinary tract infection. J Reconstr Urol. 2020;10:35-43.
14. Fernandez RS, Griffiths RD. Clamping short-term indwelling catheters: a systematic review of the evidence. J Wound Ostomy Continence Nurs. 2005;32:329-36.
15. Lynn, P. Taylor klinik hemşirelik becerileri bir hemşirelik süreci yaklaşımı (Çev. Ed. H Bektaş):595- 635. 3. Baskı. Ankara, Nobel Yayıncılık, 2015.
16. Stevens E. Bladder ultrasound: avoiding unnecessary catheterizations. Medsurg Nurs. 2005;14:249-53.
17. Roe B. Do we need to clamp catheters? Nurs Times. 1990;86:66-7.
18. Zhengyong Y, Changxiao H, Shibing Y, Caiwen W. Randomized controlled trial on the efficacy of bladder training before removing the indwelling urinary catheter in patients with acute urinary retention associated with benign prostatic hyperplasia. Scand J Urol. 2014;48:400-404.
19. Agarwal BK, Agarwal N. Randomized controlled trial on the efficacy of bladder training before removing indwelling urinary catheter in patients with acute urinary retention. International Journal of Scientific Research 2015;4:327-28.
20. Wang LH, Tsai MF, Han CS, Huang YC, Liu HE. Is bladder training by clamping before removal necessary for short-term indwelling urinary catheter inpatient? A systematic review and meta-analysis. Asian Nurs Res. 2016;10:173-81.
21. Büyükyılmaz F, Culha Y, Zümreler H, Özer M, Culha MG, Ötünçtemur A. The effects of bladder training on bladder functions after transurethral resection of prostate. J Clin Nurs. 2019:1-7.
22. Moon HJ, Chun MH, Lee SJ, Kim BR. The usefulness of bladder reconditioning before indwelling urethral catheter removal from stroke patients. Am J Phys Med Rehabil. 2012;91:681-88.
23. Talreja V, Ali A, Saeed S, Rani K, Samnani SS, Farid FN et al. Trail without catheter after transurethral resection of prostate: clamp it or not? Scientifica (Cairo). 2016:1-3.
24. Biricik E, Güneş Y. Nörocerrahi ve ERAS. Arşiv Kaynak Tarama Dergisi 2020;29:37-50.
25. Turnbull H, Burbos N, Abu-Freij M, Duncan TJ, Nieto JJ. A novel approach to postoperative bladder care in women after radical hysterectomy. Arch Gynecol Obstet. 2012;286:1007-10.
26. Griffiths R, Fernandez R. Strategies for the removal of short-term indwelling urethral catheters in adults. Cochrane Database Syst Rev. 2007;2:CD004011.