经皮肾镜取石术后患者尿潴留的相关因素分析  

Analysis of related factors of urinary retention after percutaneous nephrolithotomy

作　　者：庄小倩 彭华[1] 罗小年[3] 翟丹丹 曹姣艳 王婷婷 彭伶丽 Zhuang Xiaoqian;Peng Hua;Luo Xiaonian;Zhai Dandan;Cao Jiaoyan;Wang Tingting(Department of International Medical,Xiangya Hospital of Central South University,Changsha 410000,China;Xiangya Nursing College of Central Souh University,Changsha 410013,China;Department of Urology,Xiangya Hospital of Central South University,Changsha 410000,China)

机构地区：[1]中南大学湘雅医院国际医疗部,长沙410000 [2]中南大学湘雅护理学院,长沙410013 [3]中南大学湘雅医院泌尿外科,长沙410000 [4]不详

出　　处：《国际泌尿系统杂志》2020年第5期787-791,共5页International Journal of Urology and Nephrology

摘　　要：目的分析引起经皮肾镜取石术(PCNL)术后患者尿潴留的影响因素,探究早期识别策略与护理防治手段。方法回顾性分析本院2009年4月至2019年3月收治的3870例行PCNL的患者术后出现尿潴留的相关信息,并且与无尿潴留并发症的患者建立匹配对照,通过构建赋值模型、单(多)因素logistic回归分析,筛选出PCNL术后患者尿潴留的影响因素。运用统计学方法对本院开展的膀胱功能训练进行评估,明确其防治术后尿潴留的效果。结果PCNL术前患者体重指数(BMI)越高,术后发生尿潴留风险越大;患有糖尿病、既往有尿潴留史的患者更易发生术后尿潴留;术中选择椎管麻醉相对于全身麻醉会显著增加术后尿潴留的风险;术后导尿管留置时间长也会明显增加术后尿潴留风险;术后进行膀胱功能训练能有效降低PCNL术后尿潴留的发生率。结论对于PCNL术后患者,术前BMI高、患有糖尿病、既往有尿潴留史、术中选择椎管麻醉、术后导尿管留置时间长均是术后拔管后出现尿潴留的危险因素,需有所警惕,而拔管前进行膀胱功能训练能有效降低PCNL术后尿潴留的发生率,具有保护意义。Objective To analyze the influencing factors of urinary retention after percutaneous nephrolithotomy(PCNL),and explore the early identification strategy and preventive treatment.Methods Retrospective data of urinary retention after PCNL in our hospital from April 2009 to March 2019 was collected,these patients of urinary retention were matched with those without such complication.The influencing factors of urinary retention after PCNL were screened by establishing an assign-ment model and single or multiple conditional logistic regression analysis.At the same time,the bladder training strategies caried out in our department were evaluated by the above statistical methods to.explore its effect of preventing urinary retention.Results Patients with higher BMI before PCNL,were more likely to have urinary retention,patients having diabetes and previous history of urinary retention tended to have higher risk of urinary retention after PCNL.Intraoperative spinal anesthesia,compared with general anesthesia,could significantly increase the risk of urinary retention after.PCNL.Long time of catheter indwelling after operation can also significantly increase the risk of urinary retention.Bladder function training can effectively reduce the incidence of urinary retention after PCNL.Conclusions For patients with PCNL,high BMI before operation,diabetes mellitus,history of urinary retention,intraoperative spinal anesthesia and long indwelling time of catheter after operation are all risk factors,which requires particular attention from medical staff,for urinary retention.Bladder function training before extubation can effectively reduce the occurrence of urinary retention after PCNL.

关 键 词：尿潴留 肾造口术 经皮 糖尿病 回归分析 

分 类 号：R699.2[医药卫生—泌尿科学]