肛肠病术后尿潴留危险因素及中医综合干预预防效果分析

Preventive Effect Analysis of Risk factors for Postoperative Urinary Retention in Anorectal Diseases and TCM Comprehensive Intervention

目的:分析肛肠病术后尿潴留的危险因素及中医综合干预的预防效果。方法:回顾性分析84例肛肠病术后患者临床资料,根据是否发生尿潴留分为尿潴留组(n=17)与非尿潴留组(n=67),经logistic回归分析肛肠病术后尿潴留发生的独立危险因素,根据独立危险因素分析中医综合干预预防对策。另选取80例行肛肠手术患者为研究对象,按随机数表法分为中医综合干预组(研究组,n=40)和常规干预组(对照组,n=40),比较两组患者术后尿潴留发生率、术后排尿情况及术后首次排尿时排尿情况积分差异。结果:术中输液量≥1000 mL、术后VAS评分≥8分、术后HAMA评分≥14分、术后主诉肛门伤口处坠胀不适是影响肛肠病术后尿潴留发生的独立危险因素(P<0.05)。研究组术后尿潴留发生率、术毕至首次排尿时间、术毕至排尿完全通畅时间、术后首次排尿时排尿情况各方面积分小于对照组(P<0.05)。结论:术中输液量≥1000 mL、术后VAS评分≥8分、术后HAMA评分≥14分、术后主诉肛门伤口处坠胀不适等情况的肛肠病术后患者发生尿潴留的比例相对较高,针对可控因素进行中医综合干预可有效降低肛肠病术后患者尿潴留发生率,改善排尿情况。

Objective:To analyze the risk factors for postoperative urinary retention in anorectal diseases and the preventive effects of TCM comprehensive intervention. Methods:The clinical data of 84 patients with postoperative anorectal diseases were retrospectively analyzed. According to whether there was urinary retention or not,they were divided into urinary retention group(n=17)and non-urinary retention group(n=67). The occurrence of postoperative urinary retention in anorectal diseases was analyzed by logistic regression,and the independent risk factors were used to analyze the prevention measures of TCM comprehensive intervention. Another 80 patients who underwent anorectal surgery were enrolled in the study and were divided into TCM comprehensive intervention group(study group,n=40)and routine intervention group(control group,n=40)according to the random number table method. The incidence rate of postoperative urinary retention,postoperative urination,and the urination scores at first postoperative urination were compared between the two groups. Results:Intraoperative infusion quantity ≥ 1000 mL,postoperative VAS score ≥ 8 points,postoperative HAMA score ≥ 14 points,and postoperative complaint of bulge discomfort in anal wound were independent risk factors for postoperative urinary retention in anorectal diseases(P<0.05). The incidence rate of postoperative urinary retention,the time from the end of surgery to the first urination,the time from end of surgery to complete urination,and the urination scores at first postoperative urination in study group were lower than those in control group(P<0.05). Conclusion:Patietns with intraoperative infusion quantity ≥ 1000 mL,postoperative VAS score ≥ 8 points,postoperative HAMA score ≥ 14 points,and postoperative complaint of bulge discomfort in anal wound have a relatively high proportion of urinary retention after anorectal surgery. TCM comprehensive intervention for controllable factors can effectively reduce the incidence rate of postoperative urinary retention in patients with anorectal diseases,and improve the urination.