不同无痛导尿方法对全麻后留置尿管患者苏醒早期躁动程度比较  

Comparison of Different Methods of Painless Catheterization in Patients with Indwelling Catheter after General Anesthesia

作　　者：朱明达 景调平 张维[1] 白梦 梁华[1] ZHU Mingda;JING Tiaoping;ZHANG Wei;BAI Meng;LIANG Hua(Department of Anesthesiology,the 942th Hospital of the PLA,Yinchuan750004,China)

机构地区：[1]中国人民解放军联勤保障队第九四二医院麻醉科,银川750004

出　　处：《宁夏医科大学学报》2020年第6期642-645,共4页Journal of Ningxia Medical University

基　　金：解放军第九四二医院新技术基金(NXWY20180712)。

摘　　要：目的探讨不同无痛导尿方法对全麻后留置尿管患者苏醒早期躁动程度比较。方法选择168例围术期需留置尿管的男性患者,随机分为盐酸达克罗宁胶浆尿管前端涂抹(A)组、盐酸达克罗宁胶浆尿道内注射(B)组、盐酸达克罗宁胶浆+0.2%盐酸罗哌卡因合剂尿道内注射(C)组、石蜡油尿管前端涂抹(D)组,每组42人。分别记录患者入室即刻(T0)、意识恢复拔出气管导管即刻(T1)、术后2 h(T2)和术后4 h(T3)时的平均动脉压(mean arterial pressure,MAP)、心率(heart rate,HR);观察T1、T2、T3时患者导尿管相关膀胱刺激征(catheter related bladder discomfort,CRBD)程度并评级。结果 MAP组间与时间点之间存在交互效应(F=56.848,P<0.001),HR组间与时间点之间存在交互效应(F=52.311,P<0.001),CRBD组间与时间点之间存在交互效应(F=56.684,P<0.001)。T0时,各组间的MAP、HR值比较差异均无统计学意义(P均>0.05)。T1和T2时,A、B、C组的HR、MAP值和CRBD评级均低于D组(P均<0.05),且3组间比较差异均无统计学意义(P均>0.05)。T3时,C组的HR、MAP值和CRBD评级均低于A、B、D组(P均<0.05),B组的CRBD评级低于A组(P<0.05)。结论盐酸达克罗宁胶浆+0.2%盐酸罗哌卡因合剂尿道内注射可以降低男性全麻患者在术后CRBD引起的躁动程度。Objective To compare the early restlessness in patients with indwelling catheter after general anesthesia with different painless catheterization methods. Methods A total of 168 male patients who needed indwelling catheter during perioperative period were randomly divided into dyclonine hydrochloride mucilage catheter front application group(A),intraurethral injection of dyclonine hydrochloride mucilage group(B),intraurethral injection of dyclonine hydrochloride+0.2% ropivacaine hydrochloride mixture group(C)and application of paraffin oil catheter front end group(D). The mean arterial pressure(map)and heart rate(HR)were recorded at the time of entering the room(T0),at the time of consciousness recovery and extubation(T1),2 hours after operation(T2)and 4 hours after operation(T3);the degree of catheter-related bladder irritation(CRBD)was observed and graded at T1,T2 and T3. Results For MAP,there was interaction effect between groups and time points(F=56.848,P<0.001). For HR,there was interaction effect between groups and time points(F=52.311,P<0.001),and there was interaction effect between groups and time points for CRBD(F=56.684,P<0.001). At T0,there was no significant difference in MAP and HR among the three groups(P>0.05). At T1 and T2,HR,MAP value and CRBD rating of group A,B and C were lower than those of group D(P all<0.05),and there was no significant difference among the three groups(P>0.05). At T3,HR,MAP value and CRBD rating of group C were lower than those of group A,B and D(P all<0.05),and CRBD rating of group B was lower than that of group A(P<0.05). Conclusion Intra-urethral injection of hydrochloride dyclonine and 0.2% ropivacaine hydrochloride mixture can reduce the agitation caused by CRBD in male patients after general anesthesia.

关 键 词：盐酸达克罗宁胶浆 盐酸罗哌卡因 导管相关膀胱刺激征 全身麻醉 

分 类 号：R614.21[医药卫生—麻醉学]