留置导尿管外固定方法对男性患者短期留置导尿的影响

Influence of Different External Fixation Ways in Male Patients with Short-term Urinary Catheterization

目的比较三种留置导尿管外固定方法对男性患者短期留置导尿的影响。方法便利抽样法选取2012年1月至12月在上海交通大学医学院附属仁济医院术后需行留置导尿的男性患者44例为研究对象,按住院号尾数的不同将其分为三组,并采用3种方法对留置导尿时间<2周的患者进行外固定,内固定方式相同。外固定A组为传统固定,即将导尿管从大腿上部穿过,用别针和橡皮筋固定于床尾三分之一处;B组为大腿内侧固定,用胶布固定导尿管于患者下腹部或大腿前侧;C组为腹部固定,将阴茎及导管翻向下腹部,使之与腹壁成60°角,再固定于下腹的相应位置或腹股沟处(下腹部有切口者)。比较三组患者导尿后的尿路感染情况、舒适度、导尿管脱落情况及拔管后症状。结果三组患者均未发生尿路感染及尿管脱落现象,而C组患者舒适度优于其他两组,差异均有统计学意义(均P<0.05)。三组患者拔管后症状的差异无统计学意义。结论腹部外固定方法与目前临床采用的传统固定法和大腿内侧固定法相比,有一定的优势。

Objective To compare the influence of three different external fixation ways for male patients with short-term urinary catheter. Methods A total of 44 male patients admitted to Ren Ji Hospital from January to December 2012 ,who needed postoperative indwelling catheters, were recruited and divided into 3 groups according to the mantissa of admission number. Three different external fixation ways were applied in male patients with urinary catheter more than 2 weeks,while internal fixation ways were all the same in these three groups. In group A,the catheter through the upper thigh was fastened by clip and rubber band to the bed at the last 1/3 side,In group B,the catheter was taped on the lower abdomen or upper leg; In group C, the penis and catheter were turned upside to make sure that the angle between catheter and ventral midline is 60°, and the catheter was fastened in the relevant position on the lower abdomen or inguinal region （when there was a lower abdominal incision）. Infection rates,feelings after catheterization and symptoms after pulling out the catheter among three groups were compared. Results No patients in three groups infected during research periods. Patients in Group C felt more comfortable after catheterizing than those in other 2 groups,and the differences had statistical significance（P〈0.05）. There＇s no significant difference among three groups in symptoms after pulling out the catheter. Conclusion The external fixation way of fasten the catheter on the lower abdomen is relatively better than other two ways in male patients with short-term urinary catheterization.