适时导尿与膀胱容积关系的研究

Research on relationship between urinary bladder volume and timely catheterization

目的为避免过度导尿及延迟导尿所导致并发症的发生,依据个人膀胱容量的不同,探讨患者留置导尿的最佳时期。方法择期行外科手术患者1 840例,接受手术过程中未留置导尿管,随机分为最大膀胱容量组(实验组)和常规膀胱容量500 ml组(对照组)两组,Ⅰ组患者术前告知测量最大膀胱容量(按照实验设计统一标准),患者有强烈自主尿意时导尿,Ⅱ组患者应用彩超测量膀胱容积,当彩超测量尿量达到500 ml是导尿,比较两组患者留置导尿的比率。结果最大膀胱容量组(实验组)导尿容积为(600±189)ml,常规膀胱容量500 ml组(对照组)导尿容积为(573±156)ml,留置导尿的几率从11.2%下降到8.6%,两组均无严重并发症发生。结论手术患者根据最大膀胱容量留置尿管方法比常规膀胱容量500ml导尿的方法大大降低了导尿的几率。

Objective To avoid the occurrence of complications resulting in excessive catheterization and delayed urethral catheterization,bladder capacity according to individual difference,to explore the best period for patients with indwelling catheter. Methods Patients undergoing elective surgery in 1,840 cases,surgery in the process of indwelling catheter were randomly divided into maximum bladder capacity group（ I group） and normal bladder volume 500 ml group（ Group II） two groups,group I patients were informed before the maximum bladder capacity（ measured in accordance with the unified standard design experiment）, patients had a strong independent urine catheterization,group II patients by color Doppler ultrasound measurement of bladder volume,when the measurement of urine volume reaches 500 ml was the ratio of catheterization,compared two groups of patients with indwelling catheter. Results The average MBC in the control group was 600 ml（ ± 189 ml） and573 ml（ ± 193ml） in the index group. The incidence of catheterization decreased from 11. 2%（ 107 of 909patients） in the control group to 8. 6% in the index. There were no adverse events in either group. Conclusions MBC in patients undergoing surgery rather than regular 500 ml threshold for bladder catheterization is a safe approach that significantly reduces the incidence of postoperative bladder catheterizations.