加速康复外科模式下术前排尿训练联合限制性输液对人工全膝关节置换术患者术后排尿的影响  

Effect of preoperative urination training combined with restrictive fluid therapy with enhanced recovery after surgery on postoperative urination in total knee arthroplasty patients

作　　者：段闪闪 宁宁[1] 周婷[1] 李佩芳[1] 王科[1] 李玲利[1] 侯晓玲[1] DUAN Shanshan;NING Ning;ZHOU Ting;LI Peifang;WANG Ke;LI Lingli;HOU Xiaoling(Department of Orthopaedics,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China)

机构地区：[1]四川大学华西医院骨科,成都610041

出　　处：《华西医学》2018年第12期1491-1494,共4页West China Medical Journal

基　　金：四川省科技厅支撑项目(2018SZ0228;2018SZ0246);四川大学华西医院学科卓越发展1.3.5工程项目;ZY2016204~~

摘　　要：目的探讨加速康复外科(enhanced recovery after surgery,ERAS)模式下,术前排尿训练联合限制性输液对人工全膝关节置换术患者术后排尿的影响。方法选取2018年3月—5月,行单侧人工全膝关节置换术患者150例,随机分为试验组与对照组,每组各75例。对照组患者术前不进行排尿训练且手术当日采用自由输液方式,试验组患者术前进行排尿训练且手术当日采用限制性输液方式。记录两组患者手术当日术前、术中、术后输液量及手术当日总输液量,比较两组患者术后首次排尿方式、首次排尿时间及住院天数。结果试验组和对照组患者手术当日总输液量分别为(1 581.40±277.54)、(2 395.00±257.40)mL;试验组术后首次排尿顺利73例,诱导后顺利2例,导尿0例,对照组术后首次排尿顺利66例,诱导后顺利3例,导尿6例;试验组和对照组术后首次排尿时间分别为术后回病房(1.85±0.91)、(2.93±1.48)h;以上差异均具有统计学意义(P<0.05)。试验组和对照组住院天数分别为(5.86±2.48)、(6.28±1.60)d,差异无统计学意义(P>0.05)。结论 ERAS模式下,人工全膝关节置换术患者术前进行排尿训练并联合限制性输液(手术当日总输液量控制在1 500 mL左右),有助于患者术后顺利排尿,降低术后尿潴留的发生率,加快患者康复。Objective To study the effect of preoperative urination training combined with restrictive fluid therapy with enhanced recovery after surgery (ERAS)on postoperative urination in total knee arthroplasty (TKA)patients. Methods A total of 150patients who were conducted the unilateral TKA from March to May 2018were divided into two groups,the trial group and the control group,with 75 patients in each group.The patients in the control group did not undergo urination training before surgery and were given liberal intravenous fluid therapy on the day of surgery;while the patients in the trial group received urination training before surgery and were given restrictive fluid therapy on the day of surgery.The pre-,intra-,and post-operative infusion volume and the total infusion volume on the day of surgery of the two groups were recorded;and the urination situation,urination time for the first time and the hospital days in the two groups were compared.Results The total infusion volume on the day of surgery in the trial group and the control group was (1581.40±277.54)and (2395.00±257.40)mL,respectively.After operation,in the trial group,there were 73patients with smooth urinating,2with smooth urinating after inducing method,and none with urethral catheterization;in the control group,there were 66patients with smooth urinating,3with smooth urinating after inducing method,and 6with urethral catheterization.The urination time for the first time after operation in the trial group and the control group was(1.85±0.91)and (2.93±1.48)hours after back to the ward,respectively.These differences between the two groups were statistically significant (P<0.05).The hospital stay in the trial group and the control group was (5.86±2.48)and (6.28±1.60)days,respectively,and the difference between the two groups was not statistically significant (P>0.05). Conclusions Preoperative urination training combined with restrictive fluid therapy (the total infusion volume controls in about 1500mL on the day of surgery)in the TKA patients after E

关 键 词：加速康复外科 人工全膝关节置换术 限制性输液 排尿训练 

分 类 号：R473.6[医药卫生—护理学]