骨科下肢手术后应用静脉自控镇痛泵患者术后导尿管拔除时机的探讨-论文.pdf

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1、蚌埠医学院学报2014年7月第39卷第7期983[文章编号]1000-2200(2014)07-0983-03·护理学·骨科下肢手术后应用静脉自控镇痛泵患者术后导尿管拔除时机的探讨马杰。张萍，葛君，雷婷婷，年夫春，邵艳，朱静[摘要]目的：探讨骨科下肢手术术后应用静脉自控镇痛泵患者导尿管拔除的最佳时机。方法：随机选择2012年3月至2013年4月收治的180例下肢手术患者为研究对象，按照拔除导尿管的时机分为4组，各45例；I、Ⅱ分别于术后12、24h拔除，Ⅲ组术后48h镇痛结束时拔除，Ⅳ组于术后48h镇痛结束且膀胱充盈时拔除；I、Ⅱ组拔管前不进行夹管训练，告知患者导

2、尿管及时拔除的重要性；Ⅲ、Ⅳ组采取间歇性夹管，有尿意时开放1次。观察4组患者排尿以及尿白细胞阳性情况。结果：I组患者有效排尿率均明显低于Ⅱ组、Ⅲ组和Ⅳ组(P<0．01)；m组和Ⅳ组患者尿白细胞阳性率为20．00％和20．22％，均高于I组和Ⅱ组(P<0．05)。结论：对于骨科下肢手术后应用静脉自控镇痛泵的患者，拔除导尿管的最佳时机为术后24h。[关键词]导尿；镇痛，病人控制；外科手术[中国图书资料分类法分类号]R472[文献标志码]AResearchonthetimeofrehabilitatedcatheterforpatientswhousedthepatie

3、nt-controlledintravenousanalgesiapumpafterthesurgeryofthelowerlimbMAJie，ZHANGPing，GEJun，LEITing-ting，NIANFu-chun，SHAOYan，ZHUJing(DepartmentofOrthopaedics，eFirstAfiliatedHospitalofBengbuMedicalCollege，BengbuAnhui233004，China)[Abstract]0bjective：Toevaluatethebesttimeofrehabilitatedcathe

4、terforpatientswhousedthepatient—controledintravenousanalgesiapumpafterthesurgeryofthelowerlimb．Methods：Thedataof180patientswererandomlyselectedwhoreceivedthesurgeryofthelowerlimbfromMarch2012toApril2013．Accordingtothetimeofrehabilitatedcatheter，theyweredividedinto4groups．The45casesing

5、roup1wererehabilitatedcatheterin12hoursafterthesurgery．The45easesingroupI1wererehabilitatedcatheterin24hoursafterthesurgery．The45casesingroup11wererehabilitatedcatheterin48hoursafterthesurgeryattheendofanalgesia．The45casesingroupIVwererehabilitatedcatheterin48hoursafterthesurgeryatthe

6、timeofanalgesiaendandthebladderfilling．ThegroupIandl1werenotclippedthecatheterbeforerehabilitation．andinformedtheimportanceoftimelyrehabilitation．Thegroupmand1Vwereclippedintermittently．Theywereopenedwhenthepatientshavetourinate．Observingthesituationofthe4groupsurinationandthepositive

7、urinaryleukocyte．Results：IngroupI，thepositivevoidingrateofthepatientsweresignificantlylowerthanthoseingroupⅡ，mand1V(P<0．01)；thepositiverateofurinaryleukocyteofthepatientsingroupmandIVgroupwas20．00％and20．22％，washigherthanthoseingroupIandII(P<0．05)．Conclusions：Topatientswhousedthepatien

8、t—con