剖宫产术后拔除尿管时机的探讨

发布时间：2018-05-10 06:15

本文选题：剖宫产手术 + 留置导尿管　；参考：《临床医药文献电子杂志》2016年43期

【摘要】：目的探讨夹管后观察有尿意感时的尿量指导拔管的方法在剖宫产术后留置尿管拔管时机的作用,以确定剖宫产术后拔除尿管的最佳时机。方法选取2016年1月~2016年5月我院收治的剖宫产妇200例作为研究对象,将其随机分为对照组50例和干预组150例,又将干预组根据手术时间随机分成三个小组,各50例。对照组按常规在术后24 h夹管,等有尿意时放尿纪录单次尿量,将记录的数据作为干预组拔管时尿量标准的参考,然后直接拔管。干预组分别在术后6 h、10 h、14 h夹管,根据有尿意感时单次的放尿量来判断膀胱的功能恢复情况,指导拔管时机,根据个体差异性,拔管时机分别为大约在术后8 h、12 h和16 h左右。结果对照组在术后24 h夹管,有尿意感时尿量在150~450 m L,这一数据验证了膀胱功能恢复理论的正确性。干预组根据有尿意感时导出尿量多少作为依据,如果尿量少于350 m L,就可以拔管,拔管后三组均自解小便通畅,没有出现排尿不畅的情况。结论夹管后根据有尿意感时方尿量指导拔管时机能使剖宫产术后留置尿管时间明显缩短,拔除尿管后,没有发生尿潴留情况,也没有发生尿路感染的情况,不仅减少了产妇的痛苦,也降低了产妇发生尿路感染的风险,具有重要的临床意义。
[Abstract]:Objective to investigate the effect of indwelling catheterization after catheterization by observing urine volume after catheterization, and to determine the best time to remove urinary catheter after caesarean section. Methods 200 caesarean women treated in our hospital from January 2016 to May 2016 were randomly divided into control group (n = 50) and intervention group (n = 150). In the control group, the urine volume was recorded at 24 hours after operation. The recorded data were taken as the reference of the urine volume standard of the intervention group during extubation, and then the catheter was removed directly. In the intervention group, the bladder function recovery was judged according to the single urine volume at 6 h, 10 h and 14 h after operation. According to the individual difference, the time of extubation was about 12 h and 16 h, respectively. Results in the control group, the urine volume was 150 ~ 450 mL at 24 h after operation, which verified the validity of the theory of bladder function recovery. The intervention group was based on the amount of urine which was induced when there was a feeling of urination. If the volume of urine was less than 350 mL, the tube could be removed. After the extubation, the three groups were free of unobstructed urination and had no unobstructed urination. Conclusion the time of indwelling urethral catheter after caesarean section can be shortened obviously by guiding the time of extubation according to the quantity of urine when there is a feeling of urination. There is no urinary retention or urinary tract infection after extubation of urethra tube. It not only reduces maternal pain, but also reduces the risk of urinary tract infection.
【作者单位】：兰州市妇幼保健院产科;
【分类号】：R473.71

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