选择夹闭尿管时机对剖宫产留置镇痛泵拔管后排尿的影响

Influence of selecting time of clipping indwelling urine catheter on micturition after tube drawing of cesarean section analgesic pump

目的探讨患者剖宫产后,选用不同的方式拔出置留体中的尿管,对预防尿潴留的作用。方法收集2011年4月～2012年10月300例采取腹壁子宫下段进行横切口剖宫且置留镇痛泵的患者,将其随机分为两组,每组患者均为150例,两组均遵循医生引导,留置尿管开放8h后方可拔管。对照组按照医生指导开放导尿管8h后就拔管。而实验组也在开放8h后进行拔管,但实验组让患者输最后一瓶药液时约500mL夹闭尿管,指导患者自感膀胱充盈之时立即拔管。结果经过不同的拔管方式,实验组的产妇拔管后3.5h内的排尿量明显高于对照组产妇(P<0.01),需要重新安置导尿管的比例明显低于对照组产妇(P<0.05)。结论通过实验在一定程度上能够证明夹闭尿管后待病患有尿意后拔管,比长期开放尿管8h后再拔管更能够预防尿潴留,具有推广意义。

Objective To investigate the role of selecting different mode of pulling out the indwelling urine catheter after cesarean section in preventing urinary retention. Methods Three hundreds patients who received cesarean section through abdominal transverse incision to lower uterine segment and analgesic pump from April 2011 to October 2012, were collected and randomly assigned to two groups, 150 c^es in each group. Both groups were guided by doctor＇s in- struction and kept indwelling catheter opening for 8 hours before extubation. The urine catheters of control group pa- tients were pulled out at the time of opening for 8 hours, so do those of trial group patients but were guided to clip the catheter after infusion of last bottle fluid （about 500 mL） and pull out catheters immediately after feeling bladder fill- ing. Results By applying different mode of pulling out catheters, the urinary output in 3.5 hours after extubation of tri- al group was significantly more than that of control group （P 〈 0.01）, the proportion of lying-in women who need reset- tlement of catheter was significantly less than that of control group （P 〈 0.05）. Conclusion This trial proves at a cer- tain extent that extubation of clipping Catheter and pulling out after having micturition desire is more effective than that of pulling out after long-term opening for 8 hours in preventing urinary retention and worthy of promoting.