多模式管理缓解全麻术后尿管相关膀胱刺激症的效果探讨  

Efficacy of multimodal management on catheter-related bladder discomfort of patients under general anesthesia

作　　者：李静 郝建红 罗振国 董补怀[2] 张洁[2] Li Jing;Hao Jianhong;Luo Zhenguo(Department of Intensive Care Unit,the Fourth Hospital of Xi＇an,Xi＇an 710004)

机构地区：[1]西安市第四医院重症医学科,西安710004 [2]西安交通大学附属红会医院麻醉科,西安710054

出　　处：《陕西医学杂志》2018年第11期1403-1405,共3页Shaanxi Medical Journal

摘　　要：目的:评价多模式管理用于全麻术后尿管相关膀胱刺激(CRBD)症的缓解效果。方法:择期全身麻醉下行关节置换或矫形术患者200例,随机分为两组(n=100):实验组和对照组。实验组在围术期用不同措施管理尿管,主要措施为:术前访视和麻醉诱导前麻醉医师和主管医师宣教围术期留置尿管的必要性和可能出现的不适并给予相应的处理;用复方利多卡因乳膏代替石蜡油作为留置尿管的润滑剂和黏膜麻醉剂,术后患者苏醒后及时就尿管不适和患者沟通评估不适程度严重者给予处理;术后24h内拔除尿管。对照组常规尿管管理。记录术后恢复室两组患者尿管相关膀胱刺激症发生情况及程度。结果:实验组恢复室CRBD发生率和严重程度显著低于对照组。实验组有22例发生尿管相关膀胱刺激症显著低于对照组的38例(P<0.05),其中重度3例显著低于对照组的10例(P<0.05)。结论:多模式管理可有效缓解全麻术后尿管相关膀胱刺激症。ObjectiveTo evaluate the efficacy of multimodal management on catheter-releted bladder discomfort（CRBD） of patients uner general anesthesia.Methods：A total of 200 patients who under general anesthesia were randomly divided into the test group and control group.During perioperative period,different measures were used in the management of catheter in the test group and control group. Main measures in test group includes that：preoperative visit,the anesthesiologist and the physician-in-charge disseminated the necessity of perioperative indwelling catheter and possible discomfort, as well as appropriate treatment before anesthesia induction; paraffin oil was replaced by compound lidocaine cream as the lubricant and the mucous membrane anesthetics; during postoperative,the doctors promptly communicated with the patients about urinary discomfort and evaluated urinary discomfort; The urinary catheter was removed within 24 hours after the surgery. Conventional measures were used in the control group. The incidence and extent of symptoms of catheter-related bladder discomfort in both 2 groups were recorded.Results： Compared with control group, the incidence rate of CRBD and the degree of CRBD in anesthesia recovery was significantly lower in the test group. There were 22 cases of symptoms of catheter-related bladder discomfort in the experimental group, which were significantly lower than 38 cases in the control group（ P 〈0.05）. Among them, 3 severe cases in the experimental group were significantly lower than 10 cases in the control group（ P〈 0.05）. Conclusion： Multimodal management can relieve catheter-related bladder discomfort （CRBD） of patients under general anesthesia.

关 键 词：麻醉 全身 膀胱 多模式管理 

分 类 号：R694.5[医药卫生—泌尿科学]