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| 术后导尿管相关膀胱不适的危险因素 |
| Risk factors of catheter-related bladder discomfort in patients after surgery |
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| DOI：10.12089/jca.2020.08.009 |
| 中文关键词: 导尿管相关膀胱不适 危险因素 |
| 英文关键词: Catheter-related bladder discomfort Risk factor |
| 基金项目:安徽省高校拔尖人才项目(gxbjZD19);安徽省学术和技术带头人后备人选科研资助项目（2017H145）;皖医弋矶山医院“高峰”培育计划（GF2019J03） |
| 作者 | 单位 | E-mail | | 郭志远 | 241001,芜湖市,皖南医学院第一附属医院麻醉与重症医学科 | | | 夏炎 | 241001,芜湖市,皖南医学院第一附属医院麻醉与重症医学科 | | | 秦雪梅 | 241001,芜湖市,皖南医学院第一附属医院麻醉与重症医学科 | | | 曹迎亚 | 241001,芜湖市,皖南医学院第一附属医院麻醉与重症医学科 | | | 金孝岠 | 241001,芜湖市,皖南医学院第一附属医院麻醉与重症医学科 | | | 鲁卫华 | 241001,芜湖市,皖南医学院第一附属医院麻醉与重症医学科 | lwh683@126.com |
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| 中文摘要: |
目的 探讨术后留置导尿管患者导尿管相关膀胱不适（CRBD）的危险因素。
方法 选取本院行外科手术并留置导尿管的住院患者183例，男113例，女70例，年龄16～77岁，体重20～80 kg，ASA Ⅰ或Ⅱ级，根据CRBD诊断标准将患者分为两组：无症状组（C组）和有症状组（U组）。收集患者麻醉方式、手术时间、手术类型、插入导尿管时机、插入导尿管型号、抗胆碱能药物使用情况、导尿管润滑剂类型等。记录术后CRBD的发生情况及严重程度，采用多因素Logistic回归分析术后患者CRBD的危险因素及其与CRBD严重程度的相关性。
结果 发生CRBD患者76例（41.5%），其中轻度28例（15.3%），中度35例（19.1%），重度13例（7.1%）。多因素Logistic回归分析显示，男性（OR=2.139，95%CI 1.096~4.172，P=0.026）、麻醉后插入导尿管（OR=2.553，95%CI 1.327~4.912，P=0.005）、碘伏润滑剂（OR=2.017，95%CI 1.053~3.863，P=0.034）是术后CRBD的独立危险因素。插入导尿管时机和导尿管润滑剂类型与CRBD的严重程度有明显相关性（P<0.05）。
结论 正确的导尿时机和合理使用润滑剂可以减少术后CRBD的发生。 |
| 英文摘要: |
Objective To investigate risk factors of catheter-related bladder discomfort (CRBD) in patients after surgery.
Methods A total of 183 patients catheterized with Foley catheter undergoing operation, 113 males and 70 females, aged 16-77 years, weighing 20-80 kg, falling into ASA physical status Ⅰ or Ⅱ, were divided into asymptomatic group (group C) and symptomatic group (group U) according to the grade of CRBD. The operation time, the type of surgery, the type of anaesthesia, the time of catheterization, the size of Foley catheter, the use of anticholinergic drugs, and the type of lubricant were recorded. The incidence and severity of CRBD in patients after surgery were assessed, and the risk factors of CRBD in patients after surgery and their correlation with the severity of CRBD were identified.
Results The incidence of CRBD was 76 (41.5%), among them, 28 (15.3%) for mild, 35 (19.1%) for moderate, and 13 (7.1%) for severe. Multivariate logistic regression analysis indicated that male (OR = 2.139, 95% CI 1.096-4.172, P = 0.026), catheterized after anesthesia (OR = 2.553, 95% CI 1.327-4.912, P = 0.005), iodophor lubricant (OR = 2.017, 95%CI 1.053-3.863, P = 0.034) were independent risk factors for CRBD. The severity of CRBD was correlated with the right time of catheterization and iodophor lubricant (P < 0.05).
Conclusion Rational time of catheterization and lubricants can reduce the incidence of CRBD in patients after surgery. |
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