摘要
目的探讨在加速康复模式下脊柱外科颈、胸、腰椎手术不安置尿管患者术后排尿现状。方法选取2018年10月—2019年2月入住四川大学华西医院脊柱外科手术不安置尿管患者,使用脊柱患者围手术期不安置尿管患者术后排尿情况调查表进行相关信息收集,并根据患者术后返回病房后排尿情况分为自行排尿组、诱导排尿组、导尿组。结果共纳入患者106例,78例(73.6%)顺利自行排尿[首次排尿时间(72.18±36.33)min],20例(18.9%)经诱导后排尿[首次排尿时间(81.50±41.68)min],8例(7.5%)诱导排尿无效后安置尿管导尿[首次排尿时间(162.50±84.52)min]。单因素分析结果显示,不同手术方式、手术时间、首次排尿体位、术后疼痛程度对术后患者安置尿管差异均有统计学意义(P<0.05)。其中,3组间的手术时间、手术方式、首次排尿体位(诱导排尿组vs.导尿组除外)、术后疼痛评分(诱导排尿组vs.导尿组除外)两两比较,差异均有统计学意义(P<0.05)。其余因素两两比较,差异均无统计学意义(P>0.05)。结论加速康复模式下脊柱外科手术不安置尿管患者,大多术后可顺利自行排尿,但需根据患者的手术方式、手术时间、术后首次排尿体位等情况,早期关注存在排尿困难情况的患者,从而达到早期康复的目的。
Objective To investigate the status of urination in post-spineoperative(cervical thoracic and lumber verteb)patients under the enhanced recovery after surgery(ERAS)mode.Methods Patients who were admitted to the West China Hospital of Sichuan University from October 2018 to February 2019 were enrolled.The urination status of the patients was collected by using questionnaires.All patients were divided into normal urinating group,induced urinating group and catheterization group according to their urination status after returning to the ward.Results A total of 106 patients were included,including 78(73.6%)who urinated smoothly[the first urinating time(72.18±36.33)min],20(18.9%)who urinated after induction[the first urinating time(81.50±41.68)min],and 8(7.5%)who received catheters after induction failure[the first urinating time(162.50±84.52)min].The different operation,operation time,position of urination,and postoperative pain degree affecting the placement of urethral catheter differed from each other significantly(P<0.05).Among the three groups,the differences were statistically significant in operation time,operation methods,position of urination(except for the induced urination group vs.catheterization group)and postoperative pain degree(except for the induced urination group vs.catheterization group)in pairs(P<0.05).There was no significant difference in other factors among three groups in pairs(P>0.05).Conclusions Most post-spineoperative patients can autonomously urinate without catheter under the ERAS mode,which bases on operation methods,operation time,and the first urinating posture after the surgery.Early attention should be paid to patients with dysuresia to promote their early rehabilitation.
作者
钟尚洁
宁宁
李佩芳
陈佳丽
姚梅
罗晓玲
ZHONG Shangjie;NING Ning;LI Peifang;CHEN Jiali;YAO Mei;LUO Xiaoling(Department of Orthopedics,West China Hospital,Sichuan University/West China School of Nursing,Sichuan University,Chengdu,Sichuan 610041,P.R.China)
出处
《华西医学》
CAS
2020年第7期851-854,共4页
West China Medical Journal
关键词
加速康复
脊柱手术
排尿情况
影响因素
Enhanced recovery after surgery
Spine surgery
Urination
Influenced factors
