间断关闭自控镇痛泵对术后病人疼痛及尿潴留的影响

Effect of interruptedly closing patient-controlled intravenous analgesia pump on analgesia effect and urination in patients after surgery

目的探讨间断关闭自控镇痛泵（PCIA）对术后病人镇痛效果的影响，预防和解除术后尿潴留。方法将89例术后应用PCIA病人随机分为两组。实验组根据膀胱充盈程度，按压膀胱病人有尿意时，关闭PCIA约0．5～1h，结合诱导排尿的方法，促使病人自行排尿，无效者给予留置导尿。排尿后开放PCIA，按自控给药键，追加一次0．5ml的药液。当病人再次有尿意时，按上述方法重复操作。对照组持续使用PCIA，病人有尿意时自行排尿，经诱导排尿方法无效者给予留置导尿。结果两组术后镇痛效果比较无显著性差异（P〉0．05），两组术后留置导尿的比较有显著性差异（P〈0．05）。结论间断关闭PCIA，可以减少导尿的例数，且不影响术后病人的镇痛效果。

Objective To explore the effect of interruptedly closing patient-controlled intravenous analgesia （PCIA） pump on the analgesia effect and urination in patients after surgery, in order to prevent the incidence of urinary retention and to decrease the ratio of urethral catheterization. Methods 89 patients who accepted PCIA after operation were randomly divided into the experimental group and the control group. In the experimental group, according to filling level of urinary bladder, if patients showed urinary reflex when urinary bladder being pressed, PCIA pump were closed for 0.5- 1 hour. Then, combined with inducing method, they were promoted to urination by themselves, or they were to receive indwelling urethral catheterization if this failed. PCIA pump were opened after urination, press the self-controlled key to feed 0.5ml dose. When patients showed urinary reflex again the above process should be repeated. In the control group, PCIA pump were continuously on and patients urination by themselves. If inducing urination method did not work, indwelling urethral catheterization were to be accepted. Results There was no significant difference in analgesia effect （p〉0.05） and there was significant difference with regard to the ratio of accepting indwelling urethral catheterization （p〈0.05） between the two groups. Conclusion Interruptedly closing PCIA pump can decrease ratio of application of urethral catheterization and dose not affect the analgesia effect.