子宫颈癌根治术后尿潴留预防方法的比较

Comparison of prevention methods for postoperative urinary retention after radical vaginal trachelectomy

目的探讨子宫颈癌根治术后预防尿潴留的方法。方法2006年1月-2007年7月我院收治宫颈癌需行广泛全子宫切除加淋巴结清扫术患者157例，随机分为A、B、C组，A组拔管前3d给予1：5000高锰酸钾坐浴，每次20～30min，每日2次；B组拔管前3d给予夹管训练；C组为对照组一直开放尿管不采取任何措施直至拔管，分别予术后14d拔除尿管，并予第1次排尿后B超下测残余尿量。结果重置尿管：A组10例，B组4例，C组8例，3组两两比较，差异无统计学意义；B超下测残余尿量≥100ml：A组13例，B组7例，C组17例，B与C组相比较差异有统计学意义（P〈0．05），其余两组相比较无统计学意义。结论妇科手术后单纯高锰酸坐浴和夹管训练对预防尿潴留的效果不佳，需要采取综合措施，才能有效防止术后尿潴留的发生。

Objective To evaluate the practice of routine clampping catheter and potassium permanganate sitz bath on preventing urinary retention after radical vaginal trachelectomy. Methods One-hundred and fifty-seven patients, who sufferd from cervical carcinoma and needed extensive whole uterus resection plus lymph node clearance, were divided into 3 groups randomly. The patients in group A were given 1 ： 5 000 potassium permanganate sitz bath 20-30 minutes, twice a day lasting 3 days before pulling out the catheter; Group B patients underwent catheter clampping exercise lasting 3 days before pulling out the catheter; Group C was the control group with no intervention before pulling out of the catheter. All catheters were pulled out on 14th post-operative day, and all patients underwent B ultrasonic inspection to check the remaining quantity of urine after first micturition. Results There were 10 patients in group A who needed re-insertion of catheter, and in group B and C, there were 4 and 8 patients respectively. There were no statistical differences between any two groups. Under ultrasonic inspection, there were 13 patients with remaining urine over 100 ml in group A, 7 patients in group B and 17 patients in group C, repectively. The comparison of difference between group B and C was statistical significant. （P 〈 0.05 ） , while the comparison between the other two groups was with out statistical difference. Conclusion The use of potassium permanganate sitz bath or clampping catheter exercise is not a good measure for preventing urinary retention after this gynecotogical surgery.