全麻插管病人导尿最佳时机选择的探讨

目的探讨全麻插管病人导尿的最佳时机,以提高病人留置尿管的舒适度。方法选择2009年11月-2010年4月本院60例全麻气管内插管手术需导尿的病人,随机分为实验1组、实验2组和对照组,每组各20例。对照组在麻醉前、意识清醒时导尿;实验1组在麻醉插管后、意识丧失时导尿;实验2组在神经安定(即麻醉诱导开始时)、意识模糊时导尿。比较3组病人导尿时及麻醉苏醒时的尿道刺激反应。结果实验1组导尿时的尿道刺激反应轻于实验组2组及对照组(均P<0.01);实验2组病人苏醒时尿道刺激反应轻于实验1组及对照组(均P<0.01)。结论全麻病人在神经安定、意识模糊时导尿,能有效减轻病人麻醉苏醒期的尿道刺激反应,提高病人的舒适度,是最佳的尿管留置时机。

Objective To investigate the best timing for catheterization under general anesthesia so as to improve the comfort in patients with indwelled catheter. Methods 60 patients needing urethral catheterization during endotraeheal intubation under general anesthesia from November 2009 to April 20JO were randomly divided into experiment group l, experiment group 2 and control group in equal number. In the control group, urethral catheterization was conducted when the patients were conscious before anesthesia, in experiment group 1 it was done when the patients were unconscious after intubation during anesthesia, and in experiment group 2, it was done when the patients were subconscious after intubation, their nerves stable. The three groups were compared in respect of urethral reaction. Results The urethral reaction in experiment group 2 was milder than those in group 1 and control group （P 〈 0.01）. Conclusion When patients are subconscious after intubation, their nerves stable, it is the best time for urethral catheterization.