三阴交穴位注射新斯的明对腹式全子宫切除术后患者留置尿管的影响

目的探讨新斯的明三阴交穴位注射配合膀胱区热按摩对腹式全子宫切除术后使用硬膜外自控镇痛（PCEA）患者留置尿管时间及预防尿潴留的效果。方法将200例腹式全子宫切除术后PCEA患者随机分为实验组和对照组各100例。实验组采用新斯的明三阴交穴位注射配合膀胱区热按摩，对照组采用维生素B，三阴交穴位注射配合膀胱区热按摩，干预后拔出尿管，分别观察两组患者首次自行排尿时间，测定膀胱残余量（RUV），评定预防尿潴留的效果和不良反应的发生情况。结果实验组首次自行排尿时问早于对照组，差异有统计学意义（x^2=43．8，P〈0．01）；实验组预防尿潴留总有效率为98％，明显优于对照组的6l％，差异有统计学意义（X^2=41．7，P〈0．01）；两组患者均无心动过缓、呼吸抑制及低血压发生。结论新斯的明三阴交穴位注射配合膀胱区热按摩能有效缩短腹式全子宫切除术后PCEA患者留置尿管时问，预防尿潴留效果显著。

Effect of indwelling catheter after abdominal total hysterectomy by neostigmine injection in the acupuncture point of san yin chiao

Objective To investigate the duration of indwelling catheter and prevention of urinary retention in patients who used PCEA after abdominal total hysterectomy through neostigmine injecting in the acupuncture point of san yin chiao associated with thermo massage on vesical area. Methods 200 patients who used PCEA after abdominal total hysterectomy were randomly divided into the experimental group and the control group, each group had 100 cases. Patients in experimental group received neostigmine injecting in the acupuncture point of san yin chiao associated with thermo massage on vesical area, patients in control group received vitamin C injecting in the acupuncture point of san yin chiao associated with thermo massage on vesical area, and removed the catheter after intervention. The time to voluntary micturition was observed, the residual urine volume was measured, prevention of urinary retention and the side effect were explored. Results The time to voluntary micturition in experimental group was shorter than in control group, there was statistically significant difference( x2 =43.8,P ＜ 0. 01 ); the effective rate of urinary retention prevention in experimental group was 98%, and it was better than in control group which was 61%. There was statistically significant difference( x2 = 41.7 ,P ＜0. 01 ). No bradycardia case, no respiration inhibition case and no hypotension case in the two groups.Conclusions Necstigmine injecting in the acupuncture point of san yin chiao associated with thermo massage on vesical area can shorten the duration of indwelling catheter in patients who used PCEA after abdominal total hysterectomy and it can prevent the incidence of urinary retention.