盆底重建手术术后尿潴留的评估与处理  

Evaluation and management of urinary retention after pelvic floor reconstruction surgery

作　　者：张蕾[1] 陆叶[1] ZHANG Lei;LU Ye(Department of Obstetrics and Gy-necology,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院妇产科,北京100034

出　　处：《中国实用妇科与产科杂志》2024年第3期261-266,共6页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：中央高水平医院临床科研业务费资助(北京大学第一医院青年临床研究专项)(2023YC20)。

摘　　要：尿潴留通常被定义为膀胱充盈状态下排空能力受损导致排尿后残余尿量增加。临床中术后尿潴留(POUR)没有标准定义。与其他盆腔手术相比,尿失禁手术和脱垂手术POUR的发生率最高。其临床表现多样,体格检查可触及充盈的膀胱。早期识别POUR非常关键,推荐使用逆行检查法或自主排尿法在患者出院前进行检测。对于诊断为尿潴留的患者,推荐采用留置导尿管或清洁间歇性导尿术持续导尿,直至症状缓解。药物治疗及非药物干预治疗对于尿潴留也有一定治疗作用。当以上处理方法无法解决POUR时,可能需要更积极的手术处理。Urinary retention is generally defined as increased post-void residual urine volume due to impaired ability of bladder.However,there is no standard definition of postoperative urinary retention in clinic.Compared with other pelvic surgeries,urinary incontinence and prolapse surgeries had the highest incidence of POUR.Its clinical manifestations are varied.Physical examination can touch a full bladder.Early identification of POUR is critical,retrograde testing or voluntary urination is recommended for patients before discharge.For those who develop urinary retention,continuous catheterization or clean intermittent catheterization(CIC)is recommended until the symptoms are relieved.Drug therapy and non-drug intervention also have some effect on urinary retention.When POUR does not resolve spontaneously,more aggressive surgical management may be required.

关 键 词：术后尿潴留 盆底重建手术 逆行排尿试验 主动排尿试验 清洁间歇性导尿术 

分 类 号：R711.5[医药卫生—妇产科学]