妇科全身麻醉腹腔镜手术早期拔除导尿管对患者术后恢复的影响

doi:10.3969/j.issn.1674-490X.2024.06.007

摘要/Abstract

摘要： 目的通过探讨妇科全身麻醉(简称“全麻”)腹腔镜手术实施早期拔除导尿管对患者术后恢复的影响,为妇科全麻腹腔镜术后导尿管管理提供依据和参考。方法选取河北省某三甲医院妇科住院部收治的全麻下腹腔镜手术治疗的120例患者,随机分为对照组和干预组,各60例。对照组于常规术后次日晨拔除导尿管,干预组患者术后返回病房后,评估其恢复情况(意识完全清醒、肌力恢复正常、镇痛有效、生命体征平稳、膀胱无充盈),均符合后立即拔除导尿管。比较两组患者术后尿路感染发生率、尿道舒适度、首次排尿情况、导尿管重置率、首次下床活动时间和首次排气时间。结果干预组与对照组拔管后尿路感染发生率和导尿管重置率比较,差异均无统计学意义(P>0.05);干预组首次排尿情况和尿道舒适度均优于对照组,首次下床活动时间和首次排气时间均明显早于对照组,差异有统计学意义(P<0.05)。结论妇科全麻腹腔镜术后返回病房充分评估患者恢复情况后早期拔除导尿管,不会增加尿路感染和导尿管重置的风险,可促进患者首次排尿顺利,提高尿道舒适度,同时使患者拔管后首次下床活动时间和首次排气时间提前,加速患者术后恢复。

关键词: 妇科, 全身麻醉, 腹腔镜手术, 导尿管, 早期

Abstract: Objective To explore the effects of early removal of urinary catheter on postoperative recovery of patients undergoing gynecological laparoscopic surgery under general anesthesia and provide basis and reference for urinary catheter management after gynecological laparoscopic surgery under general anesthesia. Methods A total of 120 patients treated with laparoscopic surgery under general anesthesia were selected from the gynecological inpatient department of a Grade-IIIA hospital in Hebei province, and randomly divided into control group and intervention group, with 60 cases in each group. In the control group, the catheter was removed the next morning after the routine operation. In the intervention group, the catheter was removed immediately after the patients returned to the ward to evaluate the recovery of the patients( full consciousness, normal muscle strength, effective analgesia, stable vital signs, and no bladder filling ). The incidence of postoperative urinary tract infection, urethral comfort, first urination, catheter replacement rate, first ambulation time and first exhaust time were compared between the two groups. Results There was no significant difference in the incidence of urinary tract infection and catheter replacement rate between the intervention group and the control group(P>0.05). The first urination and urethral comfort in the intervention group were better than those in the control group, and the first spontaneous urination time, the first getting out of bed activity time and the first exhaust time were significantly earlier than those in the control group, with statistical significance(P<0.05). Conclusion Early removal of the catheter after returning to the ward to fully assess the recovery of patients after gynecological general anesthesia laparoscopic surgery will not increase the risk of urinary tract infection and catheter reset, can promote the smooth first urination of patients, improve the comfort of urethra, and advance the first spontaneous urination time, the first getting out of bed and the first exhaust time of patients after extubation, so as to accelerate the postoperative recovery of patients.

Key words: gynecology, general anesthesia, laparoscopic surgery, catheter, early stage

中图分类号:

胡浩然,康佳璐,耿伯雅,田娜,纪彩卿. 妇科全身麻醉腹腔镜手术早期拔除导尿管对患者术后恢复的影响[J]. 医学研究与教育, 2024, 41(6): 51-60.

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