复方利多卡因乳膏在心脏手术留置导尿中应用的效果评价

目的 探讨复方利多卡因乳膏在留置导尿中的表面麻醉及抗茵效果,寻求心脏手术患者最佳的留置导尿方案.方法 选择2016年11月至2017年1月该院198例择期行心脏手术患者,分为2组:利多卡因乳膏组(L组)和液状石蜡对照组(C组).在气管导管拔除后即刻、拔管后2、4h采用视觉模拟评分法(VAS)、导管相关膀胱刺激征(CRBD)评分法进行评分,并观察术后第1天及第7天尿白细胞、尿细菌数及术后第7天尿培养结果.结果 L组患者VAS评分、CRBD评分在气管导管拔除后即刻明显低于C组(P＜0.05).L组患者尿白细胞、细菌计数在术后第7天明显低于C组(P＜0.05).L组患者尿培养阳性率(5.05％)在术后第7天明显低于C组(13.13％),差异有统计学意义(P＜0.05).结论 复方利多卡因乳膏作为润滑剂留置导尿可降低心脏手术患者术后7d尿路感染的发生率,并可预防留置导尿引起的苏醒时躁动.

Evaluation of effect of compound lidocaine cream in indwelling urethral catheter in cardiac operation

Objective To evaluate the surface anesthesia and antibacterial effect of compound lidocaine cream in indwelling urethral catheter in order to seek the optimal indwelling urethral catheter scheme in cardiac surgery.Methods A total of 198 patients undergoing elective cardiac surgery in this hospital from November 2016 to January 2017 were selected and divided into the two groups:the lidocaine cream group(L) and liquid paraffin control group(C).The visual analogue scale (VAS) and catheter-related bladder discomfort(CRBD) were used immediately after tracheal catheter extubation and at 2,4 h after extubation.The number of white blood cells and bacteria in urine were observed on postoperative 1,7 d.The urine culture results were observed on postoperative 7 d.Results The VAS and CRBD scores immediately after extubation in the group L was significantly lower than that in the group C(P＜0.05).The urine WBC count and bacterial count on postoperative 7 d in the group L were significantly lower than those in the group C(P＜0.05),the positive rate of urine culture on postoperative 7 d in the group L was significantly lower than that in the group C,the difference was statistically significant(5.05％ vs.13.13％,P＜0.05).Conclusion Compound lidocaine cream as lubrication indwelling urethral catheter can decrease the incidence rate of urinary tract infection on postoperative 7 d in the patients with cardiac operation,furthermore can prevent the wake agitation caused by indwelling urethral catheter.