中老年患者肝脏部分切除术后导尿管拔除时间的研究

目的探讨中老年患者行肝脏部分切除术后拔除导尿管的最佳时机,减少拔管后尿潴留的发生。方法将2011年9月至2012年12月符合纳入标准的第二军医大学东方肝胆外科医院特需一科收治的拟行肝脏肿瘤切除术的患者100例按随机数字表法分为术后48、60、72、84、96h共5个研究组,分别于对应时间拔除导尿管,记录拔除导尿管后首次排尿时间、是否存在尿潴留、尿路感染情况等。结果不同组间拔除导尿管后首次解尿时间差异无统计学意义(F=1.798,P=0.312),不同拔管时间的尿潴留发生率差异有统计学意义(χ2=17.443,P=0.004),术后60h组发生尿潴留的风险最低。结论对于行肝脏部分切除术后的中老年患者,术后60h拔除导尿管发生尿潴留的风险最低。拔除前12h撤去镇痛泵,待膀胱充盈时拔管较为适宜。

Research of Time of Catheter Extubation of Elderly Patients Undergoing Hepatectomy

Objective To investigate the best timing of indwelling catheter for elderly patients undergoing liver resection,to reduce the incidence of urinary retention after extubation.Methods 100 patients were randomly divided into 5 groups,and time to extubate catheter in each group were 48 h,60 h,72 h,84 h,and 9 6 h postoperatively,respectively.Werecorded and analyzed the first micturition time after the catheter removed,the occurrence of urinary retention and urinary tract infection.Results There were no significant differences of the first micturition time between different groups（F=1.798,P=0.312）,there were signifi-cant differences of the incidence of urinary retention between groups（χ2=17.443,P=0.004）,the incidence of urinary retention in postoperative 60 h group is the lowest.Conclusion The incidence of urinary reten-tion in postoperative 60 h group is the lowest in patient undergoing hepatectomy,and it is appropriate to remove the analgesia pump 1 2 h before extubating catheter and wait until the bladder fulfilled.