摘要
目的 探究男性全麻患者，在麻醉前留置尿管拔出的最佳时机。方法 选择2020年2月到2022年3月来我院接受治疗的144男性全麻患者，按照入院单双号分为对照组72例与观察组72例，观察两组拔管后对尿管的耐受性及麻醉前、拔管后24 h平均血压、心率变化，确定拔出尿管的最佳时机。结果 对照组中度反应7例，占比9.72%，轻度反应18例，占比25.00%，无反应6例，占比8.33%；观察组中度反应1例，占比1.39%，轻度反应14例，占比19.44%，无反应16例，占比22.22%。观察组拔管后尿管耐受程度优于对照组（P＜0.05）；拔管前，对照组HR（72.13±1.01）次/min、SBP（125.01±0.91）mmHg、DBP（80.44±0.88）mmHg，观察组HR（73.94±0.77）次/min、SBP（123.83±0.54）mmHg、DBP（79.44±0.74）mmHg；拔管后，对照组HR（85.22±1.21）次/min、SBP（125.11±2.18）mmHg、DBP（84.06±1.21）mmHg，观察组HR（83.23±1.23）次/min、SBP（120.01±2.35）mmHg、DBP（81.12±1.36）mmHg。观察组24 h平均血压、心率显著优于拔管前以及对照组（P＜0.05）。结论 男性全麻患者麻醉前拔出导尿管，可提高患者舒适度。
关键词： 男性；全麻患者；麻醉前；留置尿管；拔出时机
Abstract
Objective To explore the best time to pull out the indwelling catheter for male patients under general anesthesia before anesthesia. Methods 144 male general anesthesia patients who were treated in our hospital from February 2020 to March 2022 were selected and divided into the control group (72 cases) and the observation group (72 cases) according to the admission single and double number. The tolerance of the two groups to the catheter after extubation and the changes of the average blood pressure and heart rate before and 24 hours after extubation were observed to determine the best time to pull out the catheter. Results In the control group, 7 cases had moderate reactions, accounting for 9.72%, 18 cases had mild reactions, accounting for 25.00%, and 6 cases had no reactions, accounting for 8.33%; In the observation group, there was 1 moderate reaction, accounting for 1.39%, 14 mild reactions, accounting for 19.44%, and 16 no reactions, accounting for 22.22%. The tolerance of the observation group was better than that of the control group (P＜0.05); Before extubation, the control group had HR (72.13 ± 1.01) times/min, SBP (125.01 ± 0.91) mmHg, and DBP (80.44 ± 0.88) mmHg, while the observation group had HR (73.94 ± 0.77) times/min, SBP (123.83 ± 0.54) mmHg, and DBP (79.44 ± 0.74) mmHg; After extubation, the control group had HR (85.22 ± 1.21) times/min, SBP (125.11 ± 2.18) mmHg, and DBP (84.06 ± 1.21) mmHg, while the observation group had HR (83.23 ± 1.23) times/min, SBP (120.01 ± 2.35) mmHg, and DBP (81.12 ± 1.36) mmHg. The 24h mean blood pressure and heart rate in the observation group were significantly better than those before extubation and those in the control group (P<0.05). Conclusion Pulling out the catheter before general anesthesia can improve the comfort of male patients.
Key words： Male; Patients under general anesthesia; Before anesthesia; Indwelling catheter; Pulling out time
参考文献 References
[1] 陈中举,田磊,杨为民,等.2016～2018年泌尿外科患者尿路感染病原菌分布及耐药性分析[J].临床泌尿外科杂志, 2020, 35(2):103-107,111.
[2] 张烁,孙立颖,熊辉.急诊留置尿管患者泌尿系病原菌分布及耐药性分析[J].中国临床药理学杂志,2021,37(15): 2051-2055.
[3] 贾静,吴小梅,王金萍.护士主导的留置导尿管拔除模式构建与实施[J].护理学杂志,2020,35(9):48-50.
[4] 梁昌卫,潘惟昕,蔡志康,等.长效抗菌材料对留置导尿管患者感染病原菌及血清炎症因子的影响[J].中国组织工程研究,2020,24(10):1580-1584.
[5] 陈慧娟,孔祥燕,李立,等.骨科患者围术期导尿管留置现状及其相关因素分析[J].实用骨科杂志,2021,27(3): 283 -285,288.
[6] Shu-Ping X U , Yu-Fang Z , You G ,et al.Optimal timing of indwelling catheterization in general anesthesia patient and patient's response to anesthesia during resuscitation[J]. Hainan Medical Journal, 2017.
[7] Mupombwa T , Baison G , Riley K A .Removal of Indwelling Catheter Following Benign Laparoscopic Hysterectomy: Does Timing Matter?[J]. Journal of Minimally Invasive Gynecology, 2020, 27(7): S117.
[8] 康薇.全麻前后留置导尿管对男性手术患者术后导尿管耐管力的影响分析[J]. 2021.
[9] 李淑芸,任冬梅.男性手术患者全麻前后留置导尿管对其术后苏醒期躁动的影响研究[J].世界最新医学信息文摘, 2019(21):2.
[10] 董静,刘莉,万美琳.全麻手术术前留置导尿管的时机选择及其对患者术后恢复的影响[J].国际泌尿系统杂志, 2019, 39(3):4.
[11] 丁雷,宋燕波,高永霞,等.男性患者留置导尿管腹部固定装置:CN201820503405.0[P]. CN208943198U [2023-07-24].