腹腔镜肾上腺手术患者尿管拔除时机的探讨

目的探讨腹腔镜肾上腺术后患者拔除尿管的最佳时机。方法将行腹腔镜肾上腺肿物切除术的患者按照术后拔除尿管的时间分为A组（6h），B组（12h）和C组（常规组），每组均选取20例患者。比较3组患者拔除尿管后的主观感觉、不良反应、术后卧床和禁食水的时间。结果A组和B组菌尿发生率分别；为35％和30％，均低于C组的85％，差异具有统计学意义（F=14．80，P=0．000），A组和B组血尿的发生率分别为25％和10％，均低于C组80％的发生率，差异具有统计学意义（F=22．98，P=0．000）。结论术后6～12h是腹腔镜肾上腺手术拔除尿管的最佳时机。可以在保证患者安全的前提下，降低血尿及菌尿的发生机率，促进患者术后恢复，促进患者舒适，减少患者住院费用，减少护理工作量，提高护理工作效率。

Discussion of the optimal time to remove urinary catheter in patients undergoing laparoscopic adrenalectomy

Objective To investigate the optimal time to remove the urinary catheter in patients undergoing laparoscopic adrenalectomy. MethodsPatients undergoing laparoscopic adrenalectomy were assigned to group A (6 h), group B ( 12 h), group C ( normal control group) with 20 cases in each. Subject feeling, adverse reactions, postoperative bed time and days of absolute diet were compared. Results The incidence of bacteriuria in group A (35％) and B (30％) were significantly lower than that of group C (85％)(F=14. 80, P =0. 000). The incidence of hematouria in group A (25％) and B (10％) were also significantly lower than that of group C ( 80％ ) ( F =22. 98, P =0. 000). Conclusions 6 - 12 hours after laparoscopic adrenalectomy are the optimal time to remove the catheter. In this manner, it can reduce the incidence of bacteriuria and hematouria, promote the postoperative recovery, thus to reduce the cost of hospitalization and improve the nursing work efficiency.