基于快速康复理论优化术后尿管应用在全膝关节置换术中的效果观察  

Effect of optimized postoperative urinary catheterization after total knee arthroplasty based on fast track theory

作　　者：尤田[1] 王霜[1] 温琴琴 胡会英[2] 肖银贵[1] 李九群[1] YOU Tian WANG Shuan WEN Qinqin HU Huiying XIAO Yingui LI Jiuqun(Department of Sport Medicine, Peking University Shenzhen Hospital, Guangdong Province, Shenzhen 518000, China Department of Ultrasonic Imaging Division, Peking University Shenzhen Hospital, Guangdong Province, Shenzhen 518000, China)

机构地区：[1]北京大学深圳医院运动医学科,广东深圳518000 [2]北京大学深圳医院超声影像科,广东深圳518000

出　　处：《中国医药导报》2017年第16期47-50,共4页China Medical Herald

基　　金：广东省深圳市科技计划项目(JCYJ20140415162338793)

摘　　要：目的基于快速康复理论,探讨优化术后尿管应用在全膝关节置换术(TKA)中的临床效果。方法选择2015年1~6月北京大学深圳医院行TKA的100例患者,按照随机数字表法分为对照组(全部常规留置尿管)50例和试验组(以膀胱>500 m L作为留置尿管的标准)50例。观察并比较术后首次自解小便的时间和尿量、尿路感染情况、排尿舒适度。结果试验组首次自解小便的时间短于对照组,差异有统计学意义(P<0.05)。试验组首次自解小便的量多于对照组,差异有统计学意义(P<0.05)。试验组排尿舒适度评分优于对照组,差异有统计学意义(P<0.05)。两组之间尿路感染率比较,差异无统计学意义(P>0.05)。结论在TKA患者的快速康复中,将膀胱残余尿>500 m L作为是否留置尿管的指征是合理和安全的,能有效地减轻患者的不适,有利于术后尽快恢复。Objective To discuss the effect of optimized postoperative urinary catheterization after total knee arthroplasty （TKA） based on fast track theory. Methods From January to June 2015, in Peking University Shenzhen Hospital, 100 patients underwent TKA were selected, according to random number table, they were divided into control group （all in- dwelling catheter） and trial group （catheterization threshold of 500 mL）, with 50 cases in each group. The time and vol- ume of first voluntary micturition, urinary tract infection, urination comfort index were observed and compared. Results The first urination time of trial group were shorter than control group, the difference was statistically significant （P 〈 0.05）. the difference was statistically significant （P 〈 0.05）, The first urination volume of trial group were more than control group, the difference was statistically significant （P 〈 0.05）. The comfort index of trial group were better than control group, the difference was statistically significant （P 〈 0.05）. The urinary tract infection rate of two groups were compared, the difference was not statistically significant （P 〉 0.05）. Conclusion In fast-track TKA, a bladder volume of 500 mL is reasonable and safe catheterization threshold, which can relieve the discomfort effectively, and speed the recovery postoperatively.

关 键 词：快速康复 留置尿管 全膝关节置换术 膀胱残余尿 

分 类 号：R687.4[医药卫生—骨科学]