腰椎骨折切开复位内固定术后镇痛期间尿管拔除时机的探讨

目的探讨全身麻醉（以下简称全麻）下腰椎骨折切开复位内固定术后镇痛期间留置尿管的拔除时机。方法将478例全麻腰椎骨折术后镇痛期间的患者按手术时间随机分为4组。甲组（116例）：术后镇痛泵应用期间自感有尿意时拔除尿管；乙组（124例）：结束镇痛同时拔除尿管；丙组（120例）：结束镇痛同时并自感有尿意时拔除尿管；丁组（118例）：镇痛泵拔除1d后拔除尿管。观察四组患者在拔除尿管后排尿顺畅情况、首次排尿时间、尿路感染、护理工时等指标。结果甲组患者在术后顺利排尿率、首次排尿时间、尿痛、尿色、护理工时方面均优于其余各组（P〈0．01）；在尿液混浊方面四组比较无差异（P〉0．05）。结论腰椎骨折患者全麻术后镇痛期间自感有尿意时是拔除尿管的最佳时机，是保证排尿成功率、减少尿潴留发生、降低尿路感染的有效护理方法，同时可减少因排尿失败需再次导尿时对患者尿道的损伤，有利于患者术后康复，提升患者舒适度。

Exploration on Indwelling Catheter Extraction Time during Analgesia for Open Reduction and Internal Fixation of Lumbar Fracture under General Anesthesia

Objective To explore indwelling catheter extraction time during analgesia for open reduction and internal fixation of lumbar fracture under general anesthesia.Methods A total of 478 patients during analgesia for open reduction and internal fixation of lumbar fracture under general anesthesia were randomized into 4 groups based on the operation time:group A(n=116) with indwelling catheter extraction when micturition desire occurred following the application of demulcent pump,group B(n=124) with indwelling ca...