全身麻醉男性患者术前留置导尿方式和时机探讨.docVIP

全身麻醉男性患者术前留置导尿方式和时机探讨 　　[摘要] 目的 探讨全身麻醉男性患者术前留置导尿方式和时机。方法 方便选取该院2012年1月―2017年6月224例需行全身麻醉患者随机分为3组，甲组在清醒状态下按常规方法导尿（69例）、乙组在麻醉诱导前5 min用盐酸利多卡因胶浆对尿道口及尿道粘膜进行表面麻醉、润滑后导尿（83例）、丙组在全身麻醉实施后，按常规方法留置导尿（72例）。比较3组患者导尿前、后的血流动力学改变、苏醒期躁动情况，及置管时、术后麻醉苏醒后对尿管的耐受性。 结果 乙组患者置管时和苏醒后的血流动力学波动均处于较低水平。乙组患者置管时尿管耐受率为93.98%，高于甲组（14.49%），略低于丙组（100.00%）；苏醒后尿管耐受率为89.16%，高于丙组（51.38%），与甲组相当（82.60%）。苏醒期乙组患者躁动发生率为18.07%，低于丙组（73.61%），与甲组大致相当（27.50%）。 结论 麻醉诱导前5 min用盐酸利多卡因胶浆对尿道口及尿道粘膜进行表面麻醉、润滑后进行留置导尿是行全身麻醉男性患者术前留置尿管的最佳方法和时机。 　　[关键词] 全身麻醉；留置导尿；血流动力学；躁动；耐受性；男性 　　[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2017）12（a）-0131-03 　　[Abstract] Objective To study the indwelling catheterization model and opportunity of general anesthesia male patients before surgery. Methods 224 cases of general anesthesia patients in our hospital from January 2012 to June 2017 were convenient selected and randomly divided into three groups， the group A with 69 cases used the routine method under the waking state， the group B with 83 cases used the lidocaine hydrochloride mucilage for superficial anesthesia of meatus urinarius and mucous membrane of urethra and catheterize patients after lubrication， the group C with 72 cases indwelled the catheterization by the routine method， and the hemodynamics changes and dysphoria during the awakening period， and tolerance to catheterization were compared between the three groups. Results The hemodynamic fluctuation of the group B at catheterization and after awakening were at a lower level， and the tolerance rate to the catheterization at indwelling catheter in the group B was higher than that in the group A， （93.98% vs 14.49%）， was slightly lower than that in the group C， （100.00%）， and the tolerance rate of catheterization after awakening was higher than that in the group C， but similar to that in the group A， （89.16% vs 51.38% vs 82.60%）， and the incidence rate of dysphoria during the awakening period was lower than that in the group C， similar to that in the group A， （18.07% vs 73.61% vs 27.50%