何玉红　黄锦依　徐晓艳

【摘要】 目的 观察简易膀胱测压对降低骨科留置尿管患者拔管后重插尿管的临床效果。方法 80例腰部及下肢手术患者， 按照随机数字表原则分为对照组和研究组， 每组40例。对照组使用常规方法进行留置尿管拔管， 未使用简易膀胱测压；研究组在拔尿管之前进行简易膀胱测压， 观察比较两组患者的首次排尿时间、排尿量、尿路刺激征及重插管情况。结果 研究组患者的首次排尿时间为（4.55±1.65）h、首次排尿量为（345.65±63.75）ml， 明显优于对照组的（3.75±1.45）h、（275.80±35.45）ml， 差异具有统计学意义（P<0.05）。研究组患者发生尿路刺激征6例， 明显少于对照组的14例， 差异具有统计学意义（P<0.05）。研究组患者的重插管率为5.00%， 明显低于对照组的20.00%， 差异具有统计学意义（P<0.05）。结论 简易膀胱测压可以有效降低骨科留置尿管患者拔管后重插尿管情况， 在临床工作中有很大的应用价值， 建议临床广泛推广使用。

【关键词】 簡易膀胱测压法；骨科留置尿管；膀胱内压；尿路刺激征

DOI：10.14163/j.cnki.11-5547/r.2017.30.012

Clinical study of simple bladder manometry in reducing urinary catheter after extubation for orthopedic patients undergoing indwelling catheter HE Yu-hong， HUANG Jin-yi， XU Xiao-yan. Second Affiliated Hospital of Guangzhou Medical University， Guangzhou 510260， China

【Abstract】 Objective To observe the clinical effect of simple bladder manometry in reducing urinary catheter after extubation for orthopedic patients undergoing indwelling catheter. Methods A total of 80 patients with lumbar and lower extremity surgery were divided by random number table method into control group and research group， with 40 cases in each group. The control group received conventional method for extubation of indwelling catheter instead of simple bladder manometry， and the research group received simple bladder manometry before extubation of urinary catheter. Observation and comparison were made on first urination time， urinary volume， urinary irritation and re-intubation condition between two groups. Results The research group had first urination time as （4.55±1.65） h，

first urination volume as （345.65±63.75） ml， which were all obviously better than （3.75±1.45） h and （275.80±

35.45） ml in the control group， and their difference was statistically significant （P<0.05）. The research group had obviously less number of urinary irritation as 6 cases than 14 cases in the control group， and the difference was statistically significant （P<0.05）. The research group had obviously lower re-intubation rate as 5.00% than 20.00% in the control group， and the difference was statistically significant （P<0.05）. Conclusion Simple bladder manometry can effectively reduce urinary catheter after extubation for orthopedic patients undergoing indwelling catheter， and has great application value in clinical work. It is recommended to be widely promoted and used in clinic.

【Key words】 Simple bladder manometry； Orthopedic indwelling catheter； Intravesical pressure； Urinary irritationendprint

在骨科的患者多需要进行手术治疗， 尤其是以下肢手术以及腰部手术居多， 麻醉方法经常采用硬膜外麻醉或者全身麻醉， 术前需插尿管， 术后需留置导尿管[1-3]。在临床中， 大部分患者在拔出导尿管后可以自行排尿， 但是仍有少部分患者在拔出尿管之后仍然不能自行排尿， 产生尿潴留的情况， 需要重新插尿管辅助排尿， 增加了患者尿路感染的可能

性[4-6]， 因此在临床上找到一个合适的方法来降低骨科留置尿管患者拔管后重插尿管是目前亟待解决的问题。本研究通过观察比较使用简易膀胱测压组和未使用简易膀胱测压组的拔管后重插尿管的情况， 评价简易膀胱测压对降低骨科留置尿管患者拔管后重插尿管的临床效果， 现报告如下。

1 资料与方法

1. 1 一般资料 选取本院2016年6月～2017年3月骨科病房收治的80例腰部及下肢手术患者， 其中男53例， 女27例， 年龄33～96岁， 平均年龄（65.5±7.3）岁。……