减轻全麻术后留置导尿管刺激症状的护理对策

Care counter measures of reducing irritation syndrome by indwelling catheter after anesthesia

目的探讨避免或减轻全麻术后留置尿管的引起的尿道刺激症状的护理对策。方法选取我院行手术的需留置导尿管的全麻患者200例,年龄20~70岁,无严重前列腺增生和严重心脑血管疾病,将其随机分成实验组和对照组各100例,实验组患者采用多模式护理措施留置导尿管,对照组于麻醉诱导后常规留置导尿管,观察两组患者术毕麻醉恢复时苏醒期的尿道疼痛、血压、呼吸、心率和躁动情况。结果观察组患者苏醒期的尿道疼痛和躁动情况明显优于对照组（P〈0.01）;观察组患者的血压、心率和呼吸变化与术前比较有所变化,但差异无统计学意义（P〉0.05）,而对照组术前与术后相比差异有统计学意义（P〈0.05）,留置了术后镇痛的患者除了苏醒期的血压、心率、呼吸较平稳外,无躁动,尿道疼痛也相对较轻。结论对全麻后留置尿管的患者采用多模式护理措施（舒适护理＋利多卡因胶浆＋术后镇痛）,能有效减轻患者手术留置尿管的痛苦,使护理更具人性化、个体化,提升＂以病人为中心＂的服务理念,值得推广应用。

Objective To investigate the care counter measures of avoiding or reducing urethral irritation caused by indwelling catheter after anesthesia.Methods 200 cases of patients with needed indwelling catheter after general anesthesia in our hospital,aged 20-70 years old,with no severe benign prostatic hyperplasia and severe cardiovascular disease were selected.They were randomly divided into experimental group and control group,each group had 100 cases.The experimental group were taken multi-modal care measures to indwell the catheter,and the control group were normally indwelt catheters after induction of anesthesia.Observe urethral pain,blood pressure,breathing,heart rate and restlessness form two groups were observed when they awoke from anesthesiathe after surgery.Results The up period urethral pain and restlessness of experimental groups were higher than the control group（P 0.01）;The blood pressure,heart rate and respiratory changes of experimental groups had changed compared with that before operation,but with no significant difference（P 0.05）,while preoperative and postoperative of the control group had significant differences（P 0.05）.The patients with postoperative pain relief had no restlessness and pain in the urethra was relatively light,in addition to the stable blood pressure,heart rate and respiratory.Conclusion Multi-modal care measures（comfort care ＋ lidocaine glue ＋ postoperative analgesia） for patients with indwelling catheter after anesthesia,can effectively reduce pain from indwelling catheter.So the care could be more humane and individual.It promotes the concept of ＂patient-centered＂ service,and it is worthy of being widely applied.