留置尿管早期定时开放对拔除尿管后排尿效果观察.DOCVIP

临床医学论文-留置尿管早期定时开放对拔除尿管后排尿效果观察 ???????????????????? 作者：黄木兰，李文娟，吴洁兰 【关键词】? 留置尿管；定时开放；排尿 　　［摘要］ 目的：预防术后留置尿管拔管后排尿困难和尿潴留，减少拔管后再次导尿。方法：随机选择腹部手术留置尿管患者60例，分观察组30例，患者采用术后第1天尿管定时开放。对照组30例，采用直接开放尿管引流，拔管前夹闭尿管。两组均在膀胱充盈有尿意时拔管。结果：观察组拔管后第1次排尿平均时间为13.93 min，第1次排尿成功率为96.7％(29/30)；对照组拔管后第1次排尿平均时间为43.90 min，第1次排尿成功率为66.7％(20/30)。结论：应用早期尿管定时开放的观察组拔管后排尿效果优于对照组。 　　［关键词］ 留置尿管；定时开放；排尿 　　Observation on the Effect of Early Urinary Catheter Time Opening for Patients Bladder Function after Their Catheter Was Removed 　　Abstract：Objective To prevent difficulty in urination or acute urinary retention after patents urinary catheter was removed,and then to avoid reinserting the urinary catheter.Methods 60 patients who underwent abdominal operation and indwelling urinary catheter were randomly selected and divided into test group and control group.The patients of the test group(30 cases)used a method of urinary catheter time opening and beginning in postoperative day 1.The control group(30 cases)used a method of open drainage and clamping the catheters before their removal.All the catheters were removed when the patients were of filling of bladder and had micturition desire.Results In the test group,the patients were to urinate for the first time in a mean time of 13.93mins after their urinary catheters were removed.The successful rate of first time to urinate was 96.7％(29/30).While it was 43.90mins and 66.7％(20/30)in the control group correspondingly.Conclusion The effect of early urinary catheter time opening was better than that of open drainage. 　　Key words：Indwelling urinary catheter;Time opening;Urination 　　腹部外科手术患者留置尿管拔管后易引起第一次排尿困难和尿潴留。常用的对策为按摩、热敷下腹部、听流水声、温水冲洗会阴等方法，对患者进行诱导排尿，但仍有20%左右的患者需要进行再次导尿［1］，既增加患者的痛苦，又增加了尿路感染的机会。为了预防拔除尿管排尿困难和尿潴留。有报道拔尿管前向膀胱内注入药液刺激排尿反射的方式［2，3］。根据排尿反射的生理特点，以自体尿液充盈膀胱有痛感来刺激排尿反射的，更符合生理特点［4］。根据这个道理我们采用手术后第1天尿管定时开放，与近年来应用直接开放尿管引流，拔管前夹闭尿管。两组均在膀胱充盈有尿意时拔管的两种方法进行对比。以寻求拔除尿管后能自行排尿的最佳方法。现将报道如下。 　　1　资料和方法 　　1.1　一般资料　病例来源于2005年在我科进行腹部手术的129例留置尿管患者。其中胃癌24例，肝癌3例，结肠癌39例，直肠癌63例，男性72例，女性57例，