肺癌患者围手术期无痛性留置导尿管的前瞻性队列研究  

Perioperative Painless Indwelling Urethral Catheter in Lobectomy of Lung Cancer:A Prospective Cohort Study

作　　者：徐志华[1] 杨梅[1] 邱舫[1] 樊骏[1] 王维[1] 林琳[1] 陈娟[1] 车国卫[1] 

机构地区：[1]四川大学华西医院胸外科,成都610041

出　　处：《中国胸心血管外科临床杂志》2016年第4期323-327,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：四川省科技厅基金资助(2015 SZ 0158);四川大学华西医院学科卓越发展1.3.5工程项目资助~~

摘　　要：目的探讨肺叶切除术中在麻醉状态下（无痛性）留置尿管临床应用效果和优势。方法前瞻性纳入2014年4～12月在四川大学华西医院胸外科单个医疗组行肺癌肺叶切除术患者133例。根据手术结束患者麻醉苏醒前是否留置尿管留将患者分为对照组（68例,常规留置尿管）和试验组（65例,不留置尿管）。比较两组患者临床效果。结果对照组全身麻醉苏醒后诉尿道刺激和苏醒期躁动发生率（13.24%,26.47%）均高于试验组（3.08%,10.77%）,且差异有统计学意义（P=0.041,P=0.022）。试验组术后尿潴留发生率（10.77%）与对照组（4.41%）的差异无统计学意义（P=0.403）;试验组术后尿道感染发生率（9.23%）低于对照组（26.47%）,差异有统计学意义（P=0.047）。试验组术后舒适度（0度,87.69%）优于对照组（48.53%）,差异有统计学意义（P=0.001）。试验组术后平均住院时间（5.00±1.60）d短于对照组（6.48±3.14）d,差异有统计学意义（P=0.004）。结论肺癌围手术期无痛性尿管留置有助于改善患者的住院舒适度并促进快速康复。Objective To evaluate the advantages of perioperative painless indwelling urethral catheters in lobectomy of lung cancer.Methods We recruited 133 patients who were scheduled for lung cancer lobectomy under general anesthesia in Department of Thoracic Surgery in West China Hospital from April through December 2014.These patients were divided into two groups including a control group（68 patients）and a trial group（65 patients）.The trial group was painless indwelled urethral catheter,and the control group was indwelled urethral catheter routinely.The clinical effectiveness between the two groups was compared.Results The rates of emergence agitation（EA）occurrence and urinary tract infection in the trial group（10.77 %,9.23 %）were reduced than those in the control group（26.47 %,26.47 %）with statistical differences（P= 0.022,P= 0.047）.And the rate of comfort level（0 degree）of the patients in the trial group（87.69 %）was significantly increased than that in the control group（48.53 %,P= 0.001）.And postoperative hospitalization duration in the trial group（5.00 ± 1.60 d）was shorter than that in the control group（6.48 ± 3.14 d,P= 0.004）.Conclusion Perioperative painless indwelling urethral catheters in lobectomy of lung cancer has benefit of improving the comfort level of the patients and promoting fast-track rehabilitation in the patients with lung cancer.

关 键 词：无痛性留置导尿管 肺叶切除术 肺癌 

分 类 号：R473.73[医药卫生—护理学]