骨科病人术后留置镇痛泵拔除尿管时机探讨

目的探讨骨科术后留置镇痛泵病人拔除尿管不同时机对排尿的影响。方法将150例骨科手术后留置尿管的病人随机分为3组各50例,甲组病人于术后48h停留置镇痛泵,镇痛泵拔除后24h拔除尿管;乙组病人于术后48h停留置镇痛泵后即拔除尿管;丙组病人于留置镇痛泵期间即拔除尿管。观察3组病人拔除尿管后排尿成功率。结果甲组拔除尿管后自然排尿成功49例,诱导排尿成功1例;乙组自然排尿成功38例,诱导成功8例,需再次导尿4例;丙组自然排尿成功28例,诱导成功2例,再次导尿20例。3组自然排尿成功率经卡方检验,差异有统计学意义。结论认为骨科手术后留置镇痛泵病人在拔除镇痛泵后24 h拔除尿管,优于留置镇痛泵期间或与镇痛泵同时拔除。

Discussion on the Time of Pulling Out the Catheter for the Patients of Orthopaedics Department with Indwelling Analgesia Pump after Surgery Operation

Objective To discuss influences of different time of pulling out the catheter for the patients of orthopaedics department after surgery on their emiction. Methods 150 patients after orthopaedics surgery were divided into three groups, with each having 50. In group A, indwelling analgesia pump was pulled out 48 hours after surgery and catheter was pulled out 24 h after analgesia pump being pulled out. In group B, catheter was pulled out when analgesia pump was pulled out 48 hours after surgery. In group C, catheter was pulled out when analgesia pump was still indwelled. Emiction in three groups after pulling out catheter was observed. Results In group A, 49 cases had successful natural emiction and 1 case had successful revulsive emiction. In group B, 38 cases had successful natural emietion, 8 had revulsive emiction and 4 needed catheter again. In group C, 28 cases had successful natural emiction, 8 had successful revulsive emiction and 20 needed catheter again. There were significant statistic differences among them by X^2 tested. Conclusion The time of pulling out the catheter for the patients of orthopaedics department after surgery should be 24 hours after analgesia being pulled out, which is better than other time.