B超引导下经皮膀胱穿刺造瘘术在高龄耐受力差尿潴留患者中的应用
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摘要
目的研究B超引导下经皮膀胱穿刺造瘘术在高龄耐受力差尿潴留患者中的应用情况。方法选择本院收治尿潴留并实施经皮膀胱穿刺造瘘术的患者56例,随机分为B超组和盲穿组,各28例。两组均常规术前准备,其中盲穿组使用盲穿法经皮膀胱穿刺造瘘术,B超组使用B超引导下经皮膀胱穿刺造瘘术。观察两组患者围术期指标(手术时间、瘘口愈合时间、住院时间)、术后各时段(术前、术后即刻、术后30 min、术后1 d)疼痛情况及术后并发症(后尿路感染、穿刺部位出血、造瘘管堵塞或脱落)。结果术后,B超组手术时间、瘘口愈合时间、住院时间均明显短于盲穿组(P<0.05);术后即刻、术后30 min,B超组VAS量表评分均低于盲穿组(P<0.05);术后,B超组发生率为7.14%,低于盲穿组32.14%(P<0.05)。结论高龄耐受力差尿潴留患者实施B超引导下经皮膀胱穿刺造瘘术手术效果较好,患者术后痛苦较少,且术后并发症发生率较低。
Objective To study the application of percutaneous paracentetic cystostomy guided by B-ultrasound in elderly patients with urinary retention and poor tolerance. Methods A total of 56 patients with urinary retention who underwent percutaneous paracentetic cystostomy in our hospital were selected and randomly divided into B-ultrasound group and blind-puncture group. The two groups were given routine preoperative preparation, and blind-puncture group was treated with percutaneous paracentetic cystostomy through blind-puncture, and B-ultrasound group was given percutaneous paracentetic cystostomy guided by B-ultrasound. Perioperative indicators(operative time, fistula healing time, hospital stay), pain at time points after operation(before operation, immediately after operation, 30 min after operation, 1 d after operation) and postoperative complications(postoperative urinary tract infection, bleeding at the puncture site, blockage or detachment of fistula tube) were observed in the two groups.Results After operation, the operative time, intraoperative blood loss, extubation time, fistula healing time and hospital stay in B-ultrasound group were significantly shorter than those in blind-puncture group(P<0.05). The scores of VAS scale immediately after operation and at 30 min after operation in B-ultrasound group were lower than those in blind-puncture group(P<0.05). After operation, the incidence rate in B-ultrasound group was lower than that in blind-puncture group(7.14% vs 32.14%)(P<0.05). Conclusion Percutaneous paracentetic cystostomy guided by B-ultrasound has good surgical effects for elderly patients with urinary retention and poor tolerance, and it has little postoperative pain and few risk of postoperative complications.
Objective To study the application of percutaneous paracentetic cystostomy guided by B-ultrasound in elderly patients with urinary retention and poor tolerance. Methods A total of 56 patients with urinary retention who underwent percutaneous paracentetic cystostomy in our hospital were selected and randomly divided into B-ultrasound group and blind-puncture group. The two groups were given routine preoperative preparation, and blind-puncture group was treated with percutaneous paracentetic cystostomy through blind-puncture, and B-ultrasound group was given percutaneous paracentetic cystostomy guided by B-ultrasound. Perioperative indicators(operative time, fistula healing time, hospital stay), pain at time points after operation(before operation, immediately after operation, 30 min after operation, 1 d after operation) and postoperative complications(postoperative urinary tract infection, bleeding at the puncture site, blockage or detachment of fistula tube) were observed in the two groups.Results After operation, the operative time, intraoperative blood loss, extubation time, fistula healing time and hospital stay in B-ultrasound group were significantly shorter than those in blind-puncture group(P<0.05). The scores of VAS scale immediately after operation and at 30 min after operation in B-ultrasound group were lower than those in blind-puncture group(P<0.05). After operation, the incidence rate in B-ultrasound group was lower than that in blind-puncture group(7.14% vs 32.14%)(P<0.05). Conclusion Percutaneous paracentetic cystostomy guided by B-ultrasound has good surgical effects for elderly patients with urinary retention and poor tolerance, and it has little postoperative pain and few risk of postoperative complications.
引文
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[9]邓晓俊,郝继东,刘四明,等.不同手术方法治疗恶性输尿管梗阻临床效果比较[J].新乡医学院学报,2016,33(1):51-54.
[10]徐啸,满立波.B超及电子膀胱软镜联合引导下耻骨上膀胱穿刺造瘘术的临床应用[J].临床泌尿外科杂志,2014,29(9):835-837.
[11]李涛,吴翔,吴进锋,等.超声引导下经皮肾穿刺造瘘术治疗恶性肿瘤相关性肾积水289例[J].中国肿瘤临床,2016,43(16):723-726.
[2]王声兴,梁培育,欧善际,等.术中膀胱穿刺造瘘及冲洗液温度对前列腺电切术后高龄患者并发症的影响[J].中国老年学杂志,2017,37(21):5367-5369.
[3]余雷,钱锋,徐哲.老年髋部骨折病人手术耐受力及术后髋关节功能的影响因素分析[J].蚌埠医学院学报,2017,42(8):1094-1097.
[4]石会乔,贾晓鹏.老年男性急性尿潴留的尿动力检查评估价值研究[J].中国地方病防治杂志,2017,32(1):80-81.
[5]孙婷,马杰,李静,等.不同人群疼痛评估常用测量工具的研究进展[J].现代临床护理,2016,15(4):72-75.
[6]李双平,王振兴,李承勇.一次性腹腔穿刺引流管在膀胱穿刺造瘘术中的应用研究[J].中国药物与临床,2018,18(5):789-790.
[7]牛乐军,金颖,刘大千,等.超声引导下经皮经肝穿刺胆管造影与置管引流32例分析[J].人民军医,2016,59(1):70-71.
[8]张志鹏,谭石,凌晓锋,等.超声引导下经皮经肝胆囊穿刺引流治疗高手术风险急性胆囊炎[J].中国微创外科杂志,2018,18(7):590-593.
[9]邓晓俊,郝继东,刘四明,等.不同手术方法治疗恶性输尿管梗阻临床效果比较[J].新乡医学院学报,2016,33(1):51-54.
[10]徐啸,满立波.B超及电子膀胱软镜联合引导下耻骨上膀胱穿刺造瘘术的临床应用[J].临床泌尿外科杂志,2014,29(9):835-837.
[11]李涛,吴翔,吴进锋,等.超声引导下经皮肾穿刺造瘘术治疗恶性肿瘤相关性肾积水289例[J].中国肿瘤临床,2016,43(16):723-726.