实用医学杂志
實用醫學雜誌
실용의학잡지
THE JOURNAL OF PRACTICAL MEDICINE
2014年
18期
2970-2972
,共3页
术后尿潴留%椎管内麻醉%危险因素%保护因素
術後尿潴留%椎管內痳醉%危險因素%保護因素
술후뇨저류%추관내마취%위험인소%보호인소
Postoperative urinary retention%Intrathecal anesthesia%Risk factors%Protective factors
目的：探讨椎管内麻醉患者术后尿潴留发生的相关因素。方法：收集2012年6月至2013年6月在我院行椎管内麻醉的骨科手术患者共230例。前瞻性分析椎管内麻醉患者术后尿潴留发生的相关因素。结果：230例椎管内麻醉骨科手术术后患者中，48例出现术后尿潴留。单因素分析示年龄、麻醉前尿液排泄、手术时间、术中补液量、麻醉用药量、术后镇痛尿潴留组与非尿潴留组差异有统计学意义（P ＜0．05）；性别、体重指数、吸烟史、麻醉方式尿潴留组与非尿潴留组差异均无统计学意义（P ＞0．05）。多因素 Logistic回归分析示年龄、手术时间、术中补液量、麻醉药量≥11．25 mg、术后镇痛等均为术后尿潴留的危险因素。其中麻醉前尿液排泄是保护性因素。结论：椎管内麻醉术后尿潴留是多因素造成的一种暂时性膀胱功能障碍的表现，围手术期适当的管理（尽量减少麻醉药量、缩短手术时间、控制术中补液量、术前尽量排空尿液）可以降低术后尿潴留的发生。
目的：探討椎管內痳醉患者術後尿潴留髮生的相關因素。方法：收集2012年6月至2013年6月在我院行椎管內痳醉的骨科手術患者共230例。前瞻性分析椎管內痳醉患者術後尿潴留髮生的相關因素。結果：230例椎管內痳醉骨科手術術後患者中，48例齣現術後尿潴留。單因素分析示年齡、痳醉前尿液排洩、手術時間、術中補液量、痳醉用藥量、術後鎮痛尿潴留組與非尿潴留組差異有統計學意義（P ＜0．05）；性彆、體重指數、吸煙史、痳醉方式尿潴留組與非尿潴留組差異均無統計學意義（P ＞0．05）。多因素 Logistic迴歸分析示年齡、手術時間、術中補液量、痳醉藥量≥11．25 mg、術後鎮痛等均為術後尿潴留的危險因素。其中痳醉前尿液排洩是保護性因素。結論：椎管內痳醉術後尿潴留是多因素造成的一種暫時性膀胱功能障礙的錶現，圍手術期適噹的管理（儘量減少痳醉藥量、縮短手術時間、控製術中補液量、術前儘量排空尿液）可以降低術後尿潴留的髮生。
목적：탐토추관내마취환자술후뇨저류발생적상관인소。방법：수집2012년6월지2013년6월재아원행추관내마취적골과수술환자공230례。전첨성분석추관내마취환자술후뇨저류발생적상관인소。결과：230례추관내마취골과수술술후환자중，48례출현술후뇨저류。단인소분석시년령、마취전뇨액배설、수술시간、술중보액량、마취용약량、술후진통뇨저류조여비뇨저류조차이유통계학의의（P ＜0．05）；성별、체중지수、흡연사、마취방식뇨저류조여비뇨저류조차이균무통계학의의（P ＞0．05）。다인소 Logistic회귀분석시년령、수술시간、술중보액량、마취약량≥11．25 mg、술후진통등균위술후뇨저류적위험인소。기중마취전뇨액배설시보호성인소。결론：추관내마취술후뇨저류시다인소조성적일충잠시성방광공능장애적표현，위수술기괄당적관리（진량감소마취약량、축단수술시간、공제술중보액량、술전진량배공뇨액）가이강저술후뇨저류적발생。
Objective To investigate the related factors for postoperative urinary retention in patients with intrathecal anesthesia. Methods Collect 230 patients of orthopaedic surgery with intrathecal anesthesia in our hospital from June 2012 to June 2013. Prospective analysis the related factors of postoperative urinary retention in patients with intrathecal anesthesia. Results 48 cases have postoperative urinary retention from 230 patients of orthopaedic surgerywith intrathecal anesthesia. Difference of urinary retention group and unurinary retention group is statistically significant (P < 0.05)in age, urine excretion before anesthesia, operation time, intraoperative rehydration, dose to anesthesia, postoperative analgesia. Difference of urinary retention group and unurinary retention group hasn’t statistical significance (P > 0.05) in Sex, body mass index, smoking history, the mode of anesthesia Age, operation time, intraoperative rehydration, anesthetic dosage ≥11.25 mg and postoperative analgesia are the risk factors of postoperative urinary retention with multiariable Logistic regression analysis. The urine excretion before anesthesia are protective factors. Conclusion postoperative urinary retention with intrathecal anesthesia is many factors caused by a temporary performance of bladder dysfunction , Perioperative appropriate management (minimize anesthetic doses, shorten the operation time, control intraoperatie rehydration , preoperative try to drain urine ) can reduce the occurrence of postoperative urinary retention.
