子宫切除术后留置尿管24小时必要性的研究  

The necessarity of in-dwelling catheters for 24 hours after hysterectomy

作　　者：秦立波[1] 顾丽萍[1] 张智虹[1] 

机构地区：[1]大庆油田总医院妇产科,黑龙江大庆163001

出　　处：《中国性科学》2010年第3期19-20,共2页Chinese Journal of Human Sexuality

摘　　要：目的:妇科手术术后留置尿管24小时很常见。本研究评估术后立即拔出导尿管是否会影响再插管、发热、症状性泌尿系感染的发生率及主观疼痛。方法:对250名接受子宫切除手术患者进行前瞻性随机对照试验,患者均不需要膀胱修补。尿管在离开手术室时拔除或术后24小时拔除。结果:患者被随机分为两组,除疼痛感其余结果没有显著差异。临床观察项目包括发热(≥38.5℃),留置尿管组6例,早期拔出尿管组5例(P=0.01);尿路感染症状两组均有3例(P=0.99),再插管留置导管组3例,早期拔出尿管组5例(P=0.17);主观疼痛早期拔出尿管组患者痛苦少于留置尿管组(P<0.001)。结论:术后早期拔出尿管的不会增加发热、尿路感染及再插管率,主观疼痛评估明显低于留置组,早期拔出尿管不伴有不良反应。Objectives： Indwelling catheters for 24 hour after operation arc used routinely in gynecologic surgery. This study assesses whether the immediate removal of an in - dwelling catheter after the operation affects the rate of recatheterization, febrile morbidity,symptomatic urinary tract infections, or subjective pain assessments. Methods： This study was a prospective randomized controlled trial comprised of 250 women who underwent hysterectomy and who did not require bladder suspension or strict fluid treatment. The in - dwelling catheter was removed either immediately after the operation or on the first day after the op- eration. Results： Patients were assigned randomly into 2 groups, with no significant differences in the outcomes, only in the perception lr pain. Clinical events included fever（≥38.5℃） that occurred in 6 patients in the in - dwelling catheter group compared with 5 patients in the early removal group （P = 0. 01 ）, symptomatic urinary tract infections in 3 patients in both groups （P = 0. 99）, and recatheterization in 3 patients in the in - dwelling catheter group compared with 5 patients in the early removal group （ P = 0. 17）. subjectively,patients in the early catheter group reported significantly less pain than did the in - dwelling group（P 〈0. 001 ）. Conclusion： The early removal of in - dwelling catheters after operation was not associated with an increased rate of febrile events, urinary tract infections, or need for recatheterization. In addition, subjective pain assessment was significantly less in the early removal group. Early removal of an in - dwelling catheter immediately after operation is not associated with adverse events.

关 键 词：留置尿管 子宫切除术 

分 类 号：R713.4[医药卫生—妇产科学]