颅内未破裂动脉瘤患者介入栓塞术后不同时机拔除导尿管的研究  

Study on the removal of urinary catheter at different times after interventional embolization in patients with unruptured intracranial aneurysm

作　　者：罗月 宿伟 丁婉玉 刘仑鑫 李伟 LUO Yue;SU Wei;DING Wanyu;LIU Lunxin;LI Wei

机构地区：[1]四川大学华西医院介入诊疗中心/四川大学华西护理学院,成都市610041 [2]四川大学华西医院神经外科

出　　处：《中华护理杂志》2022年第23期2864-2869,共6页Chinese Journal of Nursing

基　　金：四川省科技厅重点研发项目(2021YFS0204)。

摘　　要：目的探讨加速康复外科理念下,不同时机拔除导尿管对颅内未破裂动脉瘤介入栓塞术后患者的影响。方法采取便利抽样法,选取2021年10月—2022年1月四川省某三级甲等医院介入手术室收治的140例接受介入栓塞术治疗的颅内未破裂动脉瘤患者作为研究对象,采用随机数字表法将其分为试验组和对照组,每组70例。试验组在Aldrete评分≥12分后,术后2 h内拔除导尿管,对照组在术后24 h内拔除导尿管。结果共135例完成研究,试验组68例,对照组67例,两组一般资料比较,除导尿管留置时间外,其余一般资料比较,差异无统计学意义(P>0.05)。试验组出麻醉恢复室前苏醒期躁动评分及躁动率均低于对照组,差异均具有统计学意义(P=0.013,0.008)。试验组首次排尿时间晚于对照组,首次排尿量低于对照组,差异均具有统计学意义(均P<0.001);两组首次排尿情况比较,差异无统计学意义(均P>0.05)。试验组在拔管前、拔管时、拔管后2 h的疼痛视觉模拟评分均低于对照组,差异具有统计学意义(P<0.05)。结论术后2 h内拔除导尿管,有助于降低颅内未破裂动脉瘤患者介入栓塞术后苏醒期躁动率,不增加尿潴留及导尿管重置的风险,减轻患者尿道疼痛程度。在保证颅内未破裂动脉瘤患者介入栓塞术后安全的情况下,可尽早拔除导尿管。Objective To investigate the effect of catheter removal at different times on patients with unruptured intracranial aneurysm(UIA)after interventional embolization under the concept of enhanced recovery after surgery.Methods Convenience sampling method was used to select 140 patients with UIA who underwent interventional embolization in an interventional operating room of a tertiary A hospital in Sichuan Province from October 2021 to January 2022 as the research subjects.They were divided into an experimental group and a control group by table method,with 70 patients in each group.After the Aldrete score≥12 points in the experimental group,the urinary catheter was removed within 2 h after the operation,and the urinary catheter in the control group was removed within 24 h after the operation.Results A total of 135 patients were included in the study,with 68 in the experimental group and 67 in the control group.There was no significant difference in the general data between the 2 groups(P>0.05).The agitation score and agitation rate in the wake-up period before leaving the anesthesia recovery room in the experimental group were lower than those in the control group,and the difference was statistically significant(P=0.013 and P=0.008).The urine output was lower than that of the control group,and the difference was statistically significant(P<0.05).Compared with the control group,there was no significant difference in the first urination in the experimental group(P>0.05).The visual analog scores of pain in the experimental group before,during and 2 hours after the extubation were lower than those in the control group,and the difference was statistically significant(P<0.05).Conclusion Removing the urinary catheter within 2 hours after surgery can help to reduce rate of restlessness during recovery after interventional embolization in patients with UIA,not increase the risk of urinary retention and catheter replacement,and reduce the the pain of the urethra.It is recommended to remove the urinary catheter as soon as p

关 键 词：颅内动脉瘤 介入栓塞术 导尿管 基础护理 快速康复 

分 类 号：R473.74[医药卫生—护理学]