单孔胸腔镜辅助手术术中无尿管留置的应用效果

Application effect of no indwelling catheter in single port video assisted thoracoscopic surgery assisted surgery

目的研究单孔胸腔镜辅助手术(VATS)术中无尿管留置的应用效果。方法选取2014年1月至2019年1月上海市肺科医院收治的250例择期行肺楔形切或段切术治疗的患者,采用随机抽样法分为观察组和对照组,各125例。对照组围术期留置导尿管,观察组围术期不留置导尿管,比较两组术后首次下床时间、术后自行排尿间隔时间、住院时间、住院费用、下路尿症状量表(IPSS)评分、简化舒适状况量表(GCQ)评分及并发症发生率。结果观察组术后首次下床时间、术后自行排尿间隔时间及住院时间均短于对照组,住院费用少于对照组,IPSS评分低于对照组,GCQ评分高于对照组,差异均有统计学意义(均P<0.05);两组尿潴留、膀胱损伤发生率比较差异均无统计学意义(均P>0.05),观察组尿路感染、尿路刺激征的发生率显著低于对照组,差异均有统计学意义(均P<0.05)。结论VATS手术术中不留置导尿管有利于提高胸外科手术患者的康复和舒适度。

Objective To study the effect of no indwelling catheter in single port video assisted thoracoscopic surgery assisted surgery(VATS).Methods A total of 250 patients undergoing elective pulmonary wedge or segmental resection who were admitted to the hospital from January 2014 to January 2019 were enrolled.The patients were divided into observation group(n=125)and control group(n=125)by random sampling.The control group was given urinary catheter indwelling during perioperative period,while observation group was not given urinary catheter indwelling during perioperative period.The postoperative first time out of bed,interval time of postoperative voluntary urination,hospitalization time,hospitalization costs,scores of international prostate symptom score(IPSS)and general comfort questionnaire(GCQ),incidence of complications were compared between the two groups.Results The postoperative first time out of bed,interval time of postoperative voluntary urination and hospitalization time in observation group were shorter than those in control group,and hospitalization cost was less than that in control group.IPSS score of observation group was lower than that of control group,while GCQ score was higher than that of control group,and the differences were statistically significant(P<0.05).There was no significant difference in incidence of urinary retention and bladder injury between the two groups(P>0.05).The incidence of urinary tract infection and urinary tract irritation in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusions No urinary catheter indwelling during VATS is beneficial to improve rapid recovery and comfort of patients undergoing thoracic surgery.