不同麻醉方式对踝关节手术患者术后排尿方式的影响

Effect of Different Anesthesia Methods on Postoperative Urination in Patients with Ankle Joint Surgery

目的探讨不同麻醉方式对踝关节手术患者术后排尿方式的影响。方法拟行下肢骨科手术患者120例,年龄20~60岁,ASA分级Ⅰ或Ⅱ级,采用随机数字表法分为观察组(神经阻滞组)和对照组(椎管内麻醉组),每组患者60例。观察组患者接受下肢神经阻滞麻醉,对照组患者接受椎管内麻醉。采用视觉模拟评分法(Visual Analogue Scale,VAS)评价术后4 h(T1)、8 h(T2)、12 h(T3)及24 h(T4)的镇痛效果,观察术后8 h患者的排尿情况。结果观察组在术后4、8、12 h疼痛评分低于对照组,差异有统计学意义(P<0.05);两组患者术后24 h疼痛评分比较,差异无统计学意义(P>0.05);观察组自主排尿率高于对照组,留置尿管率低于对照组,差异有统计学意义(P<0.05)。结论在踝关节手术中,采取下肢神经阻滞麻醉比椎管内麻醉痛苦小、术后恢复快、患者自主排尿率高,值得临床应用及推广。

Objective To explore the different anesthetic methods on the ankle surgery in patients with postoperative micturition way and the effect of line. Methods Proposed to lower limbs orthopedics surgery patient 120 cases, aged 20~60 years, ASA class Ⅰ or Ⅱ, using the random number table method divided into observation group(nerve block group)and control group(spinal canal anesthesia group) and 60 cases of patients in each group. Patients in the observation group received lower limb nerve block anesthesia, and patients in the control group received spinal anesthesia. Visual Analogue Scale(VAS) was used to evaluate the analgesic effect of the patients at 4 h(T1), 8 h(T2), 12 h(T3) and 24 h(T4) after surgery, and the micturization of the patients at 8 h after surgery was observed. Results The pain scores of the observation group at 4 h, 8 h and 12 h after surgery were lower than those of the control group, with statistically significant differences(P<0.05). There was no statistically significant difference in pain scores between the two groups 24 h after surgery(P>0.05). The rate of spontaneous urination in the observation group was higher than that in the control group,and the rate of indwelling catheter was lower than that in the control group, with statistically significant differences(P<0.05).Conclusion In ankle joint surgery, lower extremity nerve block anesthesia is less painful than spinal anesthesia, the recovery is faster and the rate of spontaneous urination is higher, which is worthy of clinical application and promotion.