老年髋部骨折术后8~24 h内拔除尿管后尿潴留的相关因素分析  

Analysis of related factors of uroschesis after removal of catheter in 8~24 hours after hip fracture surgery in elderly patients

作　　者：孙凤伟 崔金宇 SUN Feng⁃wei;CUI Jin⁃yu(Department of Orthopedics,The First Affiliated Hospital of Harbin Medical University;De⁃partment of Endocrinology,Heilongjiang Forest Industry General Hospital,Harbin 150001,China)

机构地区：[1]哈尔滨医科大学附属第一医院骨科 [2]黑龙江森工总医院内分泌科,黑龙江哈尔滨150001

出　　处：《哈尔滨医科大学学报》2024年第5期528-532,共5页Journal of Harbin Medical University

基　　金：黑龙江省仁芯骨健康医疗救助基金课题(2021HX085)

摘　　要：目的 探讨影响老年髋部骨折术后8~24 h内拔除尿管成功排尿的影响因素,为临床制定拔除尿管标准提供依据。方法 采用目的抽样法回顾性收集2020年1月~2022年6月哈尔滨医科大学附属第一医院骨科进行髋部手术的患者654例为研究对象,采用改良拔尿管的方法在术后8~24 h内排空尿液后一次性饮水500 mL,夹闭尿管1 h左右拔除尿管,以病例对照研究的方法进行单因素分析,多因素逐步回归分析发生尿潴留的影响因素。结果 多因素回归分析结果显示:女性,是否进行术前排尿训练,疼痛,焦虑评分,术后补液量及拔管时机差异有统计学意义(P<0.05),为术后老年髋部骨折8~24 h内发生尿潴留的危险因素。结论 老年髋部骨折术后8~24 h内拔除尿管应重点考虑患者是否焦虑阳性,依从性差,未进行术前练习,术后补液量,以及合适的拔管时机,降低拔管后尿潴留的发生率。Objective To investigate the influencing factors of successful urination after opera⁃tion in elderly patients with hip fracture,and to provide basis for the standard of urination.Methods A total of 654 elderly patients who underwent hip surgery in The First Affiliated Hospital of Harbin Medical University from January 2020 to June 2022 were collected retrospec⁃tively,the modified method of catheter extraction was used to drain urine in 8~24 hours after operation and then drank 500 mL of water at one time.The catheter was clamped for about 1 hour and the catheter was removed.The single factor analysis was performed by case⁃control study method,the influencing factors of urinary retention were analyzed by multiple stepwise re⁃gression.Results The multivariate regression analysis showed that there were significant differences in female patients with or without preoperative urination training,pain,anxiety score,postoperative fluid intake,and extubation time(P<0.05),they were risk factors for postoperative urinary retention in elderly patients with hip fracture within 8~24 hours.Con⁃clusion The removal of urinary catheter in 8~24 hours after hip fracture operation in the eld⁃erly should be considered whether the patients have anxiety,poor compliance,no preoperative practice,postoperative fluid replacement,and the appropriate time of extubation to reduce the incidence of urinary retention after extubation.

关 键 词：髋部骨折 尿潴留 骨科 拔除尿管 

分 类 号：R473.6[医药卫生—护理学]