自排导尿管法在妇科微创手术中的应用效果研究

Application of self-urination catheter method in minimally invasive gynecological surgery

目的观察在妇科微创手术中应用自排导尿管法的具体效果。方法86例行卵巢囊肿微创手术的患者,动态随机化分成对照组以及观察组,各43例。对照组给予常规导尿管拔除法,观察组给予自排导尿管法。比较两组术后排尿情况,康复指标,不同阶段应激反应指标水平、疼痛介质水平及生活质量评分。结果观察组术后自行排尿率74.42%高于对照组的51.16%(χ^(2)=4.977,P<0.05)。观察组导尿管拔除时间(9.68±3.10)s短于对照组的(17.13±3.39)s,不良事件发生率2.33%低于对照组的16.28%(t=10.635,χ^(2)=4.962,P<0.05)。术后3 d,两组促肾上腺皮质激素、去甲肾上腺素、皮质醇水平无显著差异(t=1.923、0.112、0.246,P>0.05)。术后3 d,观察组前列腺素E2、神经肽Y、P物质水平分别为(219.01±17.02)pg/ml、(239.81±27.05)ng/L、(5.16±0.57)μg/ml,低于对照组的(236.40±20.73)pg/ml、(254.62±30.06)ng/L、(6.23±0.62)μg/ml(t=4.252、2.402、8.331,P<0.05)。术后1个月,观察组尿痛、尿失禁、排尿困难评分分别为(1.76±0.25)、(1.65±0.29)、(1.51±0.39)分,均低于对照组的(2.12±0.21)、(2.43±0.36)、(2.05±0.53)分(t=7.230、11.064、5.381,P<0.05)。结论在妇科微创手术中应用自排导尿管法可改善患者术后自行排尿功能,减少导尿管拔除时间及术后不良事件发生率,对患者疼痛感影响较轻,且不会额外增加患者术后应激反应,对预后有着重大意义。

Objective To observe the specific effects of self-urination catheter method in minimally invasive gynecological surgery.Methods 86 patients who underwent minimally invasive surgery for ovarian cysts were randomly divided into a control group and an observation group,with 43 patients in each group.The control group received conventional catheter removal,while the observation group received self-urination catheter method.The postoperative urination,rehabilitation indicators,stress reactions at different stages,pain mediators,and changes in quality of life were compared between the two groups.Results The postoperative spontaneous urination rate of the observation group was 74.42%,which was higher than 51.16%of the control group(χ^(2)=4.977,P<0.05).The catheter removal time in the observation group was(9.68±3.10)s,which was shorter than(17.13±3.39)s in the control group;the incidence of adverse events was 2.33%,which was lower than 16.28%in the control group(t=10.635,χ^(2)=4.962;P<0.05).3 d after surgery,there were no significant differences in the levels of corticotropin,norepinephrine and cortisol between the two groups(t=1.923,0.112,0.246;all P>0.05).3 d after surgery,the levels of prostaglandin E2,neuropeptide Y and substance P in the observation group were(219.01±17.02)pg/ml,(239.81±27.05)ng/L and(5.16±0.57)μg/ml,which were lower than(236.40±20.73)pg/ml,(254.62±30.06)ng/L and(6.23±0.62)μg/ml in the control group(t=4.252,2.402,8.331;P<0.05).1 month after surgery,the scores of urinary pain,urinary incontinence and dysuria in the observation group were(1.76±0.25),(1.65±0.29)and(1.51±0.39)points,which were lower than(2.12±0.21),(2.43±0.36)and(2.05±0.53)points in the control group(t=7.230,11.064,5.381;P<0.05).Conclusion The application of selfurination catheter method in minimally invasive gynecological surgery can improve postoperative self-urination function,reduce catheter removal time and incidence of postoperative adverse events,which have a mild impact on patient pain,and do not increase postoperative stress response.It is of great significance for prognosis.