全麻手术患者留置导尿方法与时机探讨

Approach the methods and opportunities of the urethral catheterization for patients with general anaesthesia

目的探讨全麻手术患者留置导尿的最佳时机与方法。方法对全麻手术患者留置尿管的时间和方法进行了对比研究。将90例手术患者随机分成3组各30例。Ⅰ组于全麻前10min行常规留置导尿;Ⅱ组于全麻前10min使用1%盐酸丁卡因胶浆润滑尿管及尿道口后留置导尿;Ⅲ组于全麻气管插管后常规留置导尿。结果Ⅰ组患者导尿后即刻,Ⅲ组患者全麻清醒后心率、血压分别较导尿前显著提高(P<0.05);Ⅱ组患者各时段心率、血压无明显波动。Ⅰ组、Ⅱ组患者术后舒适度较好;Ⅲ组全麻后插管患者对留置尿管过程缺乏记忆,术后舒适度较差(P<0.01)。结论为减轻留置导尿导致的患者不适,应采用Ⅱ组导尿方法,在全身麻醉前10min留置尿管。

Objective Approach the optimal methods and opportunities of the urethral catheterization for patients with general anaesthesia. Methods Ninety patients who had operation under general anesthesia were randomly divided into three groups to contrast respective time and method. Urethral catheterization was done in ten minutes before general anesthesia in first group. As the same time as the former , Urethral catheterization was done by lubricating the urinary canal and urethral orifice with amethoeaine hydrochloride mucilage in second group. In the last one, urethral catheterization was done after general anesthesia. Results Significant differences were found in blood pressure and heart rate before and after catheterization in first and last group（ P 〈 0. 05 ） , whereas no significant differences in the second group. In first and second groups, the patients had better degree of comfort comparing the last group. Conclusion To relieve the indisposition of patiens , urethral catheterization should be done according to the second group.