加速康复外科进展及妇科早期拔除尿管的研究综述

A review of enhanced recovery after surgery and early removal of urinary catheter in gynecology

加速康复外科(ERAS)理念已广泛应用于各学科,现因外科术后麻醉代谢需要及妇科盆腔手术的特殊性,绝大部分外科手术均需留置尿管,但留置导尿有诸多并发症,常见的有尿路感染、插管困难、渗漏、膀胱功能损伤、拔管困难等。本文主要对加速康复外科进展、妇科早期拔除尿管的应用及留置尿管并发症作一论述,实现缩短外科术后留置导尿管时间的目的,以减少患者尿路刺激症状、尿路感染率,及紧张焦虑的情绪,从而加速患者术后康复。

The concept of enhanced recovery after surgery has been widely used in various disciplines. Because of the need of anaesthesia and metabolism after surgery and the particularity of gynecological pelvic surgery, most surgical operations require indwelling catheter. However, indwelling catheter has many complications, such as urinary tract infection, difficult intubation, leakage, bladder function damage and difficult extubation. This article mainly discussed the progress of rehabilitation surgery and the application of early removal of ureter, and discussed the complications of indwelling catheter, in order to shorten the time of indwelling catheter after surgery, so as to reduce the symptoms of urinary tract irritation, the rate of urinary tract infection, and the nervous and anxious mood of patients, as well as accelerate the recovery of patients after surgery.