麻醉苏醒期患者的导尿管相关膀胱刺激征(CRBD)的发生机制和防治措施  

Catheter-related bladder discomfort after general anesthesia:mechanisms,treatment,and prevention

作　　者：张治明 周莹莹[1,2] 李妍婧 陈福春 Zhang Zhiming;Zhou Yingying;Li Yanjing;Chen Fuchun(Department of Anesthesiology,The first Peoples's Hospital of Chenzhou,Chenzhou Affiliated Hospital,Hengyang Medical College,University of South China,Chenzhou 423000,Hunan,China;Department of Anesthesiology,The first Peoples's Hospital of Chenzhou,The First Clinical Collage,Xiangnan University,Chenzhou 423000,Hunan,China;School of Basic Medical Science,Xiangnan University,Chenzhou 423000,Hunan,China)

机构地区：[1]南华大学衡阳医学院附属郴州医院(郴州市第一人民医院)麻醉科,湖南郴州423000 [2]湘南学院第一临床学院(郴州市第一人民医院)麻醉科,湖南郴州423002 [3]湘南学院基础医学院,湖南郴州423000

出　　处：《中国男科学杂志》2024年第5期112-118,135,共8页Chinese Journal of Andrology

基　　金：湘南学院校级科研项目(编号:2021XJ163);湖南省卫生健康委卫生适宜技术推广项目(编号:202319019440)。

摘　　要：导尿管相关膀胱刺激征(Catheter-Related Bladder Discomfort,CRBD)是全身麻醉术后留置导尿管所导致的一种膀胱刺激症状。本文综述探讨了CRBD的发生机制、分级、不良反应、治疗措施和预防措施。本文研究表明:(1)CRBD的发生可能与多种因素有关,如解剖学特点、性别和年龄、手术类型及导尿操作、麻醉时机和麻醉药物等;(2)对于CRBD的治疗,可以使用M受体阻断剂、镇痛性药物等;(3)多种预防措施可以降低CRBD的发生率,如选择合适的导尿管、导尿操作及拔管操作,使用表面麻醉药、神经区域阻滞等;(4)合适的麻醉方式和药物配伍、术前心理治疗等也有助于预防CRBD的发生。总之,本文为临床实践中预防和治疗CRBD提供有益的参考,然而,对于CRBD的具体机制和最佳治疗方法仍需进一步研究和临床验证。Catheter-related bladder discomfort(CRBD)refers to a bladder irritation syndrome caused by indwelling urinary catheters following general anesthesia.This review primarily explores the mechanisms,grading,adverse effects,treatment strategies,and preventive measures of CRBD.Key findings include:(1)CRBD occurrence is likely influenced by multiple factors such as anatomical features,gender,age,surgical type,catheterization procedures,timing of anesthesia,and anesthetic agents;(2)Treatment options for CRBD include M receptor blockers and analgesic medications;(3)Various preventive measures can reduce CRBD incidence,including appropriate catheter selection,insertion,and removal techniques,use of topical anesthetics,and regional nerve blocks;(4)Optimal anesthesia techniques,drug combinations,and preoperative psychological interventions may also help prevent CRBD.In conclusion,this article provides valuable insights into the prevention and management of CRBD in clinical practice.However,further research and clinical validation are needed to elucidate its specific mechanisms and optimal treatment strategies.

关 键 词：导尿管相关膀胱刺激征 导尿管 膀胱刺激 全身麻醉 麻醉苏醒期 

分 类 号：R614.2[医药卫生—麻醉学]