胸腔镜肺叶切除术后患者尿潴留危险因素分析
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摘要
目的:探讨胸腔镜肺叶切除患者术后尿潴留的发生情况及相关危险因素。方法:回顾分析110例胸腔镜肺叶切除患者病历资料,并通过单因素及多因素Logistic回归分析术后尿潴留发生的相关危险因素。结果:术后尿潴留的发生率为27.3%(30/110),单因素分析显示患者年龄、排尿困难史、麻醉风险评分、术中与术后输液量、是否使用麻醉镇痛泵等因素对其术后尿潴留的发生存在影响(P<0.05);Logistic回归分析表明,ASA评分>Ⅱ级、存在排尿困难史、术中输液量>1200ml、术后输液量>800ml是术后尿潴留的独立危险因素。结论:针对术前ASA>Ⅱ级、存在排尿困难史患者,医护人员术后应加强尿潴留风险管理,同时,应减少胸腔镜肺叶切除术患者围手术期不必要的液体输入,从而减少术后尿潴留的发生。
[Objective] To investigate the occurrence and risk factors of urinary retention after thoracoscopic lobectomy. [Method] The clinical data of 110 patients with thoracoscopic lobectomy were retrospectively analyzed, and the risk factors of postoperative urinary retention were analyzed by single factor and multivariate logistic regression. [Result] The incidence of postoperative urinary retention was 27.3%(30/110). Univariate analysis showed that age, history of dysuria, anesthesia risk score, intraoperative and postoperative infusion volume and whether to use an anesthetic analgesia had an impact on the occurrence of postoperative urinary retention(P<0.05). History of dysuria, ASA score >grade II, intraoperative fluid volume >1200 ml, postoperative fluid volume >800 ml were independent risk factors for postoperative urinary retention. [Conclusion] For the patients with dysuria and ASA >II before operation, the risk management of urinary retention should be strengthened and the unnecessary fluid input should be reduced during the perioperative period of thoracoscopic lobectomy, so as to prevent the occurrence of postoperative urinary retention.
[Objective] To investigate the occurrence and risk factors of urinary retention after thoracoscopic lobectomy. [Method] The clinical data of 110 patients with thoracoscopic lobectomy were retrospectively analyzed, and the risk factors of postoperative urinary retention were analyzed by single factor and multivariate logistic regression. [Result] The incidence of postoperative urinary retention was 27.3%(30/110). Univariate analysis showed that age, history of dysuria, anesthesia risk score, intraoperative and postoperative infusion volume and whether to use an anesthetic analgesia had an impact on the occurrence of postoperative urinary retention(P<0.05). History of dysuria, ASA score >grade II, intraoperative fluid volume >1200 ml, postoperative fluid volume >800 ml were independent risk factors for postoperative urinary retention. [Conclusion] For the patients with dysuria and ASA >II before operation, the risk management of urinary retention should be strengthened and the unnecessary fluid input should be reduced during the perioperative period of thoracoscopic lobectomy, so as to prevent the occurrence of postoperative urinary retention.
引文
[1] Lamonerie L,Marret E,Deleuze A,Lembert N,Dupont M,Bonnet F.Prevalence of postoperative bladder distension and urinary retention detected by ultrasound measurement[J].British journal of anaesthesia,2004,92( 4) :544-546.
[2]沈曲,李峥.术后尿潴留的预防及护理进展[J].中华护理杂志,2005,40(3):223-225.
[3]Kim K W,Lee J I,Kim J S,et al.Risk factors for urinary retention following minor thoracic surgery[J].Interactive Cardiovascular & Thoracic Surgery,2015,20(4):486.
[4]American society of Anesthesidogists.New classification of physical status[J].Anesthesidogy.1963,24:111.
[5]黄燕芳,刘雪芳,陈芳.中西医结合护理干预对痔疮术后疼痛及尿潴留的影响[J].中国社区医师,2014,30(7):115-116.
[6]Nazarko L.Effective evidence-based catheter management:an update[J].Br J Nurs,2010,19(15):948-953.
[7]赵戈锋.胆囊及甲状腺疾病患者术后尿潴留相关因素分析及术前是否留置尿管探讨[D].山西医科大学,2011.
[8]徐志华,杨梅,邱舫,等.肺癌患者围手术期无痛性留置导尿管的前瞻性队列研究[J].中国胸心血管外科临床杂志,2016,23(4):323-327.
[2]沈曲,李峥.术后尿潴留的预防及护理进展[J].中华护理杂志,2005,40(3):223-225.
[3]Kim K W,Lee J I,Kim J S,et al.Risk factors for urinary retention following minor thoracic surgery[J].Interactive Cardiovascular & Thoracic Surgery,2015,20(4):486.
[4]American society of Anesthesidogists.New classification of physical status[J].Anesthesidogy.1963,24:111.
[5]黄燕芳,刘雪芳,陈芳.中西医结合护理干预对痔疮术后疼痛及尿潴留的影响[J].中国社区医师,2014,30(7):115-116.
[6]Nazarko L.Effective evidence-based catheter management:an update[J].Br J Nurs,2010,19(15):948-953.
[7]赵戈锋.胆囊及甲状腺疾病患者术后尿潴留相关因素分析及术前是否留置尿管探讨[D].山西医科大学,2011.
[8]徐志华,杨梅,邱舫,等.肺癌患者围手术期无痛性留置导尿管的前瞻性队列研究[J].中国胸心血管外科临床杂志,2016,23(4):323-327.