全麻术后患者超早期拔除尿管的临床研究

目的 探讨全麻术后患者在麻醉恢复室超早期拔除尿管的可行性及临床实施效果。方法 选择甲乳外科、肝胆外科、耳鼻咽喉科择期全麻手术患者217例,按随机数字表法分为干预组（113例）和对照组（114例）。干预组经评估Steward评分≥1分（即对痛刺激有反应）在麻醉恢复室实行超早期拔除尿管方案,对照组术后第1天拔除尿管。结果 干预组导尿管相关膀胱刺激征、尿管相关性疼痛、麻醉苏醒期躁动发生率或严重程度均低于对照组（P<0.05）;2组拔管后尿管重置率、自行排尿情况比较差异无统计学意义（P>0.05）。结论 全麻术后患者在麻醉恢复室超早期拔除尿管是安全可行的,减轻了患者尿道疼痛或尿路不适等负性体验,还降低了麻醉苏醒期躁动发生率,同时不增加拔管后尿管重置率。

Super Early Removal of Urinary Catheter in Patients after General Anesthesia

Objective To explore the feasibility and clinical effect of super early removal of urinary catheter in patients after general anesthesia in post anesthesia recovery room (PACU). Methods A total of 217 patients from department of breast and thyroid surgery, department of hepatobiliary surgery and department of otorhinolaryngology were randomly divided into intervention group (n=113) and control group (n=114). With Steward scoring≥1, patients in the intervention group conducted super early removal of urinary catheter in PACU and those in the control group removed urinary catheter the day after the surgery. Results The incidence and severity of catheter-related bladder discomfort (CRBD), catheter-associated pain and agitation in anesthesia recovery period in the intervention group were lower or less than those in the control group (P<0.05); the incidence of catheter replacement and voluntary urination in the two groups indicated no statistical significance (P>0.05). Conclusion It is practical to conduct super early removal of urinary catheter in patients after general anesthesia in PACU, which reduces CRBD and the incidence of agitation in anesthesia recovery period but the incidence of catheter replacement is not increased.