前列腺增生症合并急性尿潴留常规导尿失败后再次导尿方法研究

Investigation of re-catheterizationin patients with benign prostatic hyperplasia and acute urinary retention after failure of routine indwelling catheterization

目的探讨2种导尿法运用于前列腺增生症合并急性尿潴留常规导尿失败病例中的安全性及有效性。方法本研究为随机对照研究。便利抽样选取2020年1月至2021年12月因前列腺增生症合并急性尿潴留于北京航天总医院泌尿外科行常规导尿法失败的患者80例, 采取随机数字表法分为观察组和对照组, 各40例。观察组使用12 Fr(1 Fr ≈ 0.33 mm)硅胶Foley导尿管, 将其前端折叠2 cm后进行导尿;对照组使用16 Fr硅胶前端弯曲的Coudé导尿管进行导尿。比较2组导尿成功率、导尿管插入膀胱时间、导尿后肉眼血尿发生率、导尿过程疼痛视觉模拟评分(VAS)。结果观察组导尿成功率为82.5%(33/40), 高于对照组的62.5%(25/40), 差异有统计学意义(χ^(2) = 4.01, P<0.05);2组肉眼血尿发生率、导尿管插入膀胱时间及VAS比较差异均无统计学意义(均P>0.05)。结论自制改良12 Fr硅胶Foley尿管前端折叠法运用于前列腺增生症合并急性尿潴留患者常规导尿失败后再次导尿成功率高, 且不良反应未见明显增加, 值得推广。

Objective To investigate the safety and efficacy of two methods for urethral catheterization in patients with benign prostatic hyperplasia and acute urinary retention after failure of routine indwelling catheterization.Methods This was a randomized controlled study.From January 2020 to December 2021,80 patients with benign prostatic hyperplasia complicated with acute urinary retention who failed of catheterization by conventional methods in the Department of Urology,Beijing Aerospace General Hospital were divided into observation group and control groupaccording to the random number table method,with 40 patients in each group.The observation group used a 12 Fr silicone Foley catheter,which was folded 2 cm in front of the catheter.The control group used a 16 Fr silicone curved Coude catheter.The success rate of catheterization,catheterization time,incidence of gross hematuria after catheterization,and Visual Analog Scale(VAS)were compared between the two groups.Results The success rate of catheterization in the observation group was 82.5%(33/40),which was significantly higher than 62.5%(25/40)in the control group,and the difference was statistically significant(X^(2)=4.01,P<0.05).There was no significant difference in the incidence of gross hematuria,the time of catheterization from urethra into bladder and VAS between the two groups(all P>0.05).Conclusions Technique for manipulating a 12 Fr catheter before insertion into urethral meatus in a difficult catheterization has high success rate and not significantly increases the side effects in patients with benign prostatic hyperplasia with acute urinary retention after failure of routine indwelling catheterization.