床旁超声对危重患者长期留置导尿管后拔管及膀胱功能恢复的影响

Effect of Bedside Ultrasound on Extubation and Recovery of Bladder Function after Long-term Indwelling Urinary Catheter in Critically Ill Patients

目的探讨床旁超声对危重患者长期留置导尿管后拔管及膀胱功能恢复的影响。方法选取我院2018年3月至2019年12月收治的60例长期导尿危重患者,将其分为对照组(n=30,常规夹闭尿管,每3小时开放尿管1次)和观察组(n=30,床旁超声评估膀胱容量,根据患者膀胱充盈量确定开放时间),观察两组急性生理与慢性健康评分(APACHEⅡ)、输尿管相关症状评分(USSQ评分)、并发症发生及尿管拔除重置情况。结果观察组患者APACHEⅡ评分中的年龄评分无明显差异(P>0.05),急性生理评分、慢性健康评分高于对照组(P<0.05);观察组患者USSQ评分高于对照组(P<0.05);观察组并发症总发生率20.00%低于对照组的36.66%(P<0.05);观察组自行排尿率80.00%高于对照组46.67%(P<0.05),两组患者的诱导排尿无统计学差异(P>0.05)。结论通过床旁超声对危重患者长期留置导尿后拔管效果较好USSQ评分及APACHEⅡ评分表现出明显优势,可减少并发症的发生,提高自行排尿能力。

Objective To investigate the effects of bedside ultrasound on extubation and bladder function recovery after long-term indwelling urinary catheter in critically ill patients.Methods A total of 60 critically ill patients with long-term catheterization admitted to our hospital from March 2018 to December 2019 were selected as study subjects and divided into control(n=30 with conventional urinary bladder clamping and one opening urine tube every 3 hours)and observation(n=30 with bedside ultrasound to assess bladder capacity and the opening time was selected according to the bladder filling volume of the patients)groups according to the simple and random method,and two groups were observed for acute physiology and chronic health score(APACHe II),ureter related symptom score(ussq score),occurrence of complications and reset of urinary catheter removal.Results There was no significant difference in age scores among APACHE II scores among patients in the observation group(P>0.05),acute physiology scores or chronic health scores were higher(P<0.05),patients in the observation group had higher ussq scores(P<0.05),the total incidence of complications in the observation group was 20.00%lower than 36.66%in the control group(P<0.05),the self urination rate in the observation group was higher than that in the control group(P<0.05),and patients in both groups.However,there was no statistical difference in the rates of induced voiding or urinary tube reset between the groups(P>0.05).Conclusion The better ussq score and APACHE II score obtained by bedside ultrasound after extubation with long-term indwelling catheterization in critically ill patients showed significant advantages,which may reduce the occurrence of complications and improve the ability to urinate spontaneously.