全麻下行腹部手术不同导尿时机与老年男性患者术后并发症的相关性调查

Correlation between different catheterization timing and postoperative complications in elderly male patients undergoing abdominal surgery under general anesthesia

目的 探讨分析全麻下行腹部手术不同导尿时机与老年男性患者术后并发症的相关性.方法 选取2018年11月至2020年11月在宣城市中心医院接受全麻下腹部手术的195例老年男性患者作为研究对象,采用随机数字表法将其分为A组(入手术室后麻醉诱导前实施导尿)、B组(麻醉后5 min实施导尿)、C组(麻醉后10 min实施导尿),每组各65例.观察三组患者的手术相关指标、不同时间点心率和血压的变化,并分析三组患者术后留置导尿管的舒适度、苏醒期躁动、导尿管相关膀胱刺激征(CRBD)及尿道黏膜损伤情况.结果 三组患者的手术时间、麻醉时间、麻醉苏醒时间、拔管时间比较,差异均无统计学意义(均P>0.05).导尿时、导尿后三组患者的心率、收缩压、舒张压相比,差异均有统计学意义(均P<0.05),且A组患者的各指标明显高于C组(P<0.05).导尿时,A、B组患者的心率较导尿前明显加快,A组患者的收缩压、舒张压较导尿前均明显升高;C组患者的心率、收缩压、舒张压均较平稳.C组患者的术后留置导尿管舒适度明显高于A组和B组患者,苏醒期躁动发生率明显低于A组和B组,CRBD发生率明显高于A组患者(均P<0.05).C组患者导尿后的1次尿液非肾小球性红细胞阳性率明显低于A组,B组和C组患者导尿后的2次尿液非肾小球性红细胞阳性率均明显低于A组(均P<0.05).结论 麻醉后10 min导尿时患者的血流动力学较平稳,术后留置导尿管舒适度较高,且苏醒期躁动发生率及尿道黏膜损伤程度较低,但CRBD发生率较高.

Objective To investigate the correlation between different catheterization timing and postoperative complications in elderly male patients undergoing abdominal surgery under general anesthesia.Methods A total of 195 elderly male patients who received lower abdominal surgery under general anesthesia in Xuancheng central hospital from November 2018 to November 2020 were selected as the research objects.The patients were randomly divided into group A(catheterization was performed before anesthesia induction after entering the operating room),group B(catheterization was performed 5 minutes after anesthesia)and group C(catheterization was performed i0 minutes after anesthesia)with 65 patients in each group.Operation-related indexes,heart rate and blood pressure changes at different time points of the three groups were observed,and the comfort level of indwelling catheters,agitation during recovery,catheter-related bladder irritation sign(CRBD)and urethral mucosa injury of the three groups were analyzed.Results There were no significant differences in operation time,anesthesia time,anesthesia recovery time and extubation time among the three groups(all P>0.05).There were no significant differences in heart rate,systolic blood pressure and diastolic blood pressure among the three groups before catheterization(all P>0.05).There were statistically significant differences in heart rate,systolic blood pressure and diastolic blood pressure among the three groups during and after catheterization(all P<0.05),and the indexes of group A were significantly higher than those of group C(P<0.05).During urethral catheterization,the heart rate of group A and group B was significantly faster than that before urethral catheterization,and the systolic and diastolic blood pressure of group A was significantly higher than that before urethral catheterization.The heart rate,systolic blood pressure and diastolic blood pressure of group C were stable.The comfort of postoperative indwelling catheter in group C was significantly higher than that in group A and group B,the incidence of agitation during recovery was significantly lower than that in group A and group B,and the incidence of CRBD was significantly higher than that in group A(all P<0.05).The positive rate of group C after catheterization was significantly lower than that of group A and B,and the positive rate of group B and group C after catheterization was significantly lower than that of group A for two times(all P<0.05).Conclusions During urethral catheterization 10 min after anesthesia,the hemodynamics of patients are stable,the postoperative indwelling catheter is more comfortable,and the incidence of agitation and urethral mucosa injury during the recovery period is lower,but the incidence of CRBD is higher.