全身麻醉下腹腔镜精索静脉曲张高位结扎术后不留置尿管探索研究

目的探讨全身麻醉下腹腔镜精索静脉曲张高位结扎术后是否需要留置尿管及其影响研究。方法收集2014年5月至2015年12月该院收治的男性精索静脉曲张患者110例作为研究对象,随机分为试验组(不留置尿管)和对照组(留置尿管),每组各55例。收集两组患者临床资料,术前、术后尿常规,泌尿系感染发生率,术后膀胱刺激征、尿潴留、血尿、尿道疼痛及伤口愈合等情况,并进行各项护理满意度研究和分析。结果与对照组相比,试验组患者在腹腔镜下精索静脉曲张高位结扎术后不留尿管能显著减低患者泌尿系感染率(10.90%vs.1.80%)、膀胱刺激征(89.10%vs.7.20%)、血尿(16.40%vs.0.00%)、Ⅰ级尿道疼痛(76.50%vs.1.81%)等发生率,差异均有统计学意义(P0.05),并且不增加患者术后尿潴留的风险率。在护理方面,腹腔镜下精索静脉曲张高位结扎术后不留置尿管能显著提高患者对护理服务态度、护理操作技术、尿道护理的满意度,并提高患者对护理满意度。结论全身麻醉下腹腔镜精索静脉曲张高位结扎术后不留置尿管能显著降低患者术后泌尿系感染、膀胱刺激征、血尿、尿道疼痛等发生率,并且能显著提高患者护理满意度。

Exploration of non-indwelling catheter after high ligation of laparoscopic varicocele under general anesthesia

Objective To investigate the effect of indwelling catheter and its effect after high ligation of laparoscopic varicocele under general anesthesia .Methods Totally 110 male patients with varicocele who were admitted to the hospital from May 2014 to December 2015 were included in the study ,randomly divided into experimental group (not indwelling catheter) and control group (indwelling catheter) ,55 cases in each group .The clinical data ,preoperative and postoperative urinary tract infection ,urinary tract infection rate ,postoperative bladder irritation ,urinary retention ,hematuria ,urethral pain and wound healing ,etc .of two groups were collected ,and to carry out the research and analysis of nursing satisfaction .Results Compared with the control group ,the experi‐mental group patients in laparoscopic varicocele ligation after leaving the catheter could significantly reduce the patients with urinary tract infection (10 .90% vs .1 .80% ) ,the difference was statistically significant (P< 0 .05) ,bladder irritation (89 .10% vs . 7 .20% ) ,hematuria (16 .40% vs .0 .00% ) ,incidence rate of grade Ⅰ urethral pain (76 .50% vs .1 .81% ) ,and did not increase the risk of postoperative urinary retention rate .In nursing ,laparoscopic ligation of varicocele without leaving the catheter can signifi‐cantly improve the patients′ satisfaction to nursing service attitude ,nursing operation technique ,specific urethra nursing ,and im‐prove the overall patient satisfaction with care .Conclusion Under general anesthesia ,laparoscopic varicocele ligation can signifi‐cantly reduce postoperative urinary tract infection ,bladder irritation ,hematuria ,urethral pain and other incidences ,and can signifi‐cantly improve patient care satisfaction .