单孔腹腔镜右半结肠癌根治术后尿管拔除时机探讨  

Discussion on the timing of urinary tube removal after radical resection of right hemicolonic carcinoma by single hole laparoscopy

作　　者：金田力 袁文正 付涛 Jin Tianli;Yuan Wenzheng;Fu Tao(Department of Gastrointestinal Surgery,Renmin Hospital of Wuhan University,Wuhan Hubei Province 430060,China;Department of General Surgery,Qingdao Municipal Hospital,Qingdao Shandong Province 266071,China)

机构地区：[1]武汉大学人民医院胃肠外科,武汉430060 [2]青岛市立医院普外科,山东青岛266071

出　　处：《中华普外科手术学杂志（电子版）》2024年第3期271-274,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：国家自然科学基金(81902435)。

摘　　要：目的分析单孔腹腔镜右半结肠癌根治术后尿管拔除的最佳时机,为促进患者快速康复提供新的思路或方向。方法回顾性分析2020年1月至2021年1月医院收治的右半结肠癌患者资料,患者均行单孔腹腔镜根治术治疗,遵循相关标准从中筛选出手术结束后2 d拔除导尿管的45例患者为2 d组,将手术结束后5 d拔除导尿管的45例患者为5 d组。采用SPSS 25.0软件处理数据,两组患者急性尿潴留、尿管相关性感染、拔管后72 h控尿率等计数资料用[例(%)]表示,采用χ^(2)检验;尿动力学指标等计量资料以(x±s)表示,行独立样本t检验。P<0.05为差异有统计学意义。结果拔管后12 h内,5 d组患者急性尿潴留发生率6.7%低于2 d组22.2%,差异有统计学意义(χ^(2)=4.406,P=0.036);拔除导尿管48 h内,5 d组患者尿管相关性感染率17.8%高于2 d组2.2%(χ^(2)=4.444,P=0.035);两组患者拔管后72 h控尿率及最大膀胱测压容量(MCC)、膀胱残余尿量(RUV)、最大尿流率(Qmax)比较,差异无统计学意义(P>0.05)。结论与术后2 d拔管相比,单孔腹腔镜右半结肠癌根治术后5 d的拔管尿管相关性感染发生率较高,但急性尿潴留发生率较低,临床可根据患者具体情况选择拔管时机。Objective Discussion on the timing of urinary tube removal after radical resection of right hemicolonic carcinoma by single hole laparoscopy.Methods Data of patients with right half colon cancer admitted to the hospital from January 2020 to January 2021 were retrospectively analyzed.All patients underwent single-hole laparoscopic radical resection.Clinical data of 45 patients with 2 d catheter removal after surgery were selected as the 2 d group according to relevant standards,and 45 patients with 5d catheter removal after surgery were selected as the 5 d group.SPSS 25.0 software was used to process the data.The statistical data of acute urinary retention,catheter-associated infection,and urinary control rate 72 h after extubation in the two groups were expressed by[cases(%)]andχ^(2)test was used.Measurement data such as urodynamic indexes were expressed as(x±s),and independent sample t test was performed.P<0.05 was statistically significant.Results Within 12 h after extubation,the incidence of acute urinary retention in the 5 d group was 6.7%lower than that in the 2 d group,with statistical significance(χ^(2)=4.406,P=0.036).Within 48 hours after catheter removal,the catheter-related infection rate in the 5 d group was 17.8%higher than that in the 2 d group(χ^(2)=4.444,P=0.035).There was no significant difference in urinary control rate,maximum bladder pressure volume(MCC),bladder residual urine volume(RUV)and maximum urine flow rate(Qmax)between the two groups at 72 h after extubation(P>0.05).Conclusion Compared with 2 d postoperative extubation,the incidence of extubation urinary tube-associated infection was higher at 5 d after radical extubation of right colon cancer by single hole laparoscopy,but the incidence of acute urinary retention was lower.Clinically,extubation timing could be selected according to the specific conditions of patients.

关 键 词：结肠肿瘤 单孔 腹腔镜 导尿管 时机 

分 类 号：R735.35[医药卫生—肿瘤]