术前导尿时机选择对患者尿管耐受性的影响

Time Selection of Preoperative Catheterization for Urinary Catheter Tolerance in Surgical Patients

目的:探讨全麻手术前不同时间留置尿管对手术患者尿管耐受性的影响。方法:将240例全麻手术患者随机分成A组、B组、C组,每组各80例,分别在手术室全麻诱导前(A组)、手术室全麻诱导后(B组)、回病房后(C组)留置尿管,观察置管时、术后苏醒期、全麻清醒时3个时段患者对尿管的耐受情况。结果:置管时,B组患者尿管耐受率100%,显著高于A组、C组(P<0.05);A组患者尿管0级耐受率高于C组(P<0.05),1级耐受率低于C组(P<0.05),而A组、C组患者尿管2级耐受率无显著差异(P>0.05)。术后苏醒期,B组患者尿管0级耐受率、1级耐受率显著低于A组、C组(P<0.05),尿管2级耐受率、3级耐受率显著高于A组、C组(P<0.05);A组、C组2组相比,无显著性差异(P>0.05)。全麻清醒时3组患者尿管耐受率无显著性差异(P>0.05)。结论:手术室全麻诱导前留置尿管,患者痛苦相对较小并顺利度过麻醉苏醒期,是术前留置尿管的最佳时机。

Objective： To explore the optimum time of urinary catheterization for general anesthesia patients in order to increase the degree of comfort. Methods：240 patients who underwent abdominal surgery in our hospital were divided into three groups. Preoperative catheterization was performed before（group A） and after（group B） general anesthesia in operating room, in wards （ group C）, respectively. Urinary catheter tolerance was observed. Results： At the time of urinary catheterization, the rate of urinary catheter tolerance in group B＇was 100%, which was significantly higher than that of group A and C （P 〈 0. 05 ）, and urinary catheter tolerance in group A was higher than that of group C （P 〈 0. 05）. During anesthesia analepsia, urinary catheter tolerance in group A and C was higher than that of group B （P 〈 0.05 ）, and there was no difference between group A and C （ P 〉 0. 05 ）. After returning to conscious, no difference of urinary catheter tolerance was observed in three groups （P 〉 0.05 ）. Conclusion：The optimum time of urinary catheterization for general anesthesia patients is before the anesthesia.