骨科下肢手术后应用静脉自控镇痛泵患者术后导尿管拔除时机的探讨

    Research on the time of rehabilitated catheter for patients who used the patient-controlled intravenous analgesia pump after the surgery of the lower limb

    • 摘要: 目的:探讨骨科下肢手术术后应用静脉自控镇痛泵患者导尿管拔除的最佳时机。方法:随机选择2012年3月至2013年4月收治的180例下肢手术患者为研究对象,按照拔除导尿管的时机分为4组,各45例;Ⅰ、Ⅱ分别于术后12、24 h拔除,Ⅲ组术后48 h镇痛结束时拔除,Ⅳ组于术后48 h镇痛结束且膀胱充盈时拔除;Ⅰ、Ⅱ组拔管前不进行夹管训练,告知患者导尿管及时拔除的重要性;Ⅲ、Ⅳ组采取间歇性夹管,有尿意时开放1次。观察4组患者排尿以及尿白细胞阳性情况。结果:Ⅰ组患者有效排尿率均明显低于Ⅱ组、Ⅲ组和Ⅳ组(P<0.01);Ⅲ组和Ⅳ组患者尿白细胞阳性率为20.00%和20.22%,均高于Ⅰ组和Ⅱ组(P<0.05)。结论:对于骨科下肢手术后应用静脉自控镇痛泵的患者,拔除导尿管的最佳时机为术后24 h。

       

      Abstract: Objective: To evaluate the best time of rehabilitated catheter for patients who used the patient-controlled intravenous analgesia pump after the surgery of the lower limb.Methods: The data of 180 patients were randomly selected who received the surgery of the lower limb from March 2012 to April 2013.According to the time of rehabilitated catheter,they were divided into 4 groups.The 45 cases in group Ⅰ were rehabilitated catheter in 12 hours after the surgery.The 45 cases in group Ⅱ were rehabilitated catheter in 24 hours after the surgery.The 45 cases in group Ⅲ were rehabilitated catheter in 48 hours after the surgery at the end of analgesia.The 45 cases in group Ⅳ were rehabilitated catheter in 48 hours after the surgery at the time of analgesia end and the bladder filling.The group Ⅰ and Ⅱ were not clipped the catheter before rehabilitation,and informed the importance of timely rehabilitation.The group Ⅲ and Ⅳ were clipped intermittently.They were opened when the patients have to urinate.Observing the situation of the 4 groups' urination and the positive urinary leukocyte.Results: In group Ⅰ,the positive voiding rate of the patients were significantly lower than those in group Ⅱ,Ⅲ and Ⅳ(P<0.01);the positive rate of urinary leukocyte of the patients in group Ⅲ and Ⅳ group was 20.00% and 20.22%,was higher than those in group Ⅰ and Ⅱ(P<0.05).Conclusions: To patients who used the patient-controlled intravenous analgesia pump after the surgery of the lower limb,the best time to rehabilitate catheter is 24 hours after surgery.

       

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