盐酸达克罗宁胶浆对行上段输尿管钬激光碎石术全麻病人术后留置导尿管反应的影响

目的观察应用盐酸达克罗宁胶浆对行上段输尿管钬激光碎石术后留置导尿管病人术后躁动不适的影响。方法择期行上段输尿管钬激光碎石术男性病人60例，随机分为C组和A组，各30例。C组病人于手术结束时采用传统方法留置导尿管，A组病人经尿道注入盐酸达克罗宁胶浆后再留置导尿管。监测病人术前30 min（t₀）和术后30 min（t₁）、3 h（t₂）、6 h（t₃）、12 h（t₄）、24 h（t₅）的平均动脉血压（MAP）、心率（HR）及血浆肾上腺素和去甲肾上腺素水平；观察病人全身麻醉苏醒时间、苏醒期躁动情况和术后1 h（T₁）、3 h（T₂）、6 h（T₃）、12 h（T₄）、24 h（T₅）、48 h（T₆）的VAS评分。结果与t₀比较，C组病人t₁~t₃时刻血浆E和NE水平及MAP、HR均明显升高（P < 0.01），而A组病人以上指标t₁~t₂时刻均升高（P < 0.05~P < 0.01）；t₁~t₃时刻A组病人血浆E和NE水平及MAP、HR均明显低于C组（P < 0.01）。麻醉苏醒期A组病人RASS评分明显优于C组（P < 0.01）。术后T₁~T₄时刻A组病人VAS评分均明显低于C组（P < 0.01）。结论男性病人术后留置导尿管前应用盐酸达克罗宁胶浆可有效减少病人苏醒期躁动的发生，并可减轻术后留置导尿管的不适感。

Effect of dacronine hydrochloride glue on the reaction of indwelling urethral catheter in patients treated with upper ureteral holmium laser lithotripsy under general anesthesia

ObjectiveTo observe the effects of dacronine hydrochloride glue on the postoperative restlessness and discomfort of indwelling urethral catheter in patients treated with upper ureteral holmium laser lithotripsy.MethodsSixty male patients scheduled by upper ureteral holmium laser lithotripsy were randomly divided into the group C and group A.The group C was treated with indwelling catheter at the end of operation, and the group A was treated with indwelling catheter at the end of transurethral injection of dacronin hydrochloride.The mean arterial blood pressure(MAP), heart rate(HR) and plasma concentrations of epinephrine and norepinephrine were monitored at 30 min before surgery(t₀), and at 30 min(t₁), 3 h(t₂), 6 h(t₃), 12 h(t₄) and 24 h(t₅) after surgery.The recovery time, agitation and VAS scores at 1 h(T₁), 3 h(T₂), 6 h(T₃), 12 h(T₄), 24 h(T₅) and 48 h(T₆) after the operation of general anesthesia were observed in two groups.ResultsCompared at t₀, the levels of E, NE, MAP and HR in C group at t₁ to t₃, and group A at t₁ to t₂ significantly increased(P < 0.05 to P < 0.01).At t₁ to t₃, the levels of E, NE, MAP and HR in group A were significantly lower than those in group C(P < 0.01).The RASS score in group A during anesthesia recovery period was significantly better than that in group C(P < 0.01).The VAS score in group A was significantly lower than that in group C at T₁ to T₆ after surgery(P < 0.01).ConclusionsThe application of dacronine hydrochloric acid gel before indwelling urethral catheter in male patients after surgery can effectively reduce the occurrence of agitation during the recovery period and discomfort of the indwelling urethral catheter.