剖宫产放置导尿管及拨除导尿管的时机选择(1)
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【中图分类号】R719.8；R472.9+2 【文献标识码】A【文章编号】1003-8183-(2011)09-0022-02
【摘要】目的：探讨剖宫产病人放置导尿管及拔除导尿管的最佳时期。方法：215例产妇随机分成3组，A组麻醉前在病房导尿，常规术后24h拔除导尿管；B组在手术室联合麻醉后5min导尿，常规术后24h拔除导尿管；C组在手术室联合麻醉后5min导尿，于术后12h输液结束之前拔除导尿管。根据导尿后2次尿标本中是否检出红细胞来判决有无尿道粘膜损伤，B、C两组拔管后取中段尿细菌培养，尿液中细菌数≥105/L，即为尿路感染。结果 A、B组尿道粘膜损伤率均存在差异B组显著低于A组(P<0.05)；B、C组拔管后尿路感染发生率均存在差异C组显著低于B组P<0.01(χ2=16.175)。结论：联合阻滞麻醉后是放置导尿管的最佳时期，导尿可减少尿道粘膜损伤；术后12h输液结束前拔除导管对预防细菌逆行感染及尿潴留起到积极作用，是拔除导尿管最佳时期。
【关键词】剖宫产；导尿管；留置导尿管
Catheter Placement and Cesarean Section in Addition to Call the Timing of Catheter
Tan Liping， He Yuanlian
【Abstract】Objective：To investigate the cesarean section patient catheter and the removal of the catheter to place the best time. Methods： 215 cases of maternal randomly divided into 3 groups， A group of anesthesia in the ward before the catheterization， routine catheter removal after 24h； B group combined anesthesia in the operating room 5min after catheterization， routine catheter removal after 24h； C in the operating room anesthesia group 5min after catheterization， at 12h after removal of the catheter before the end of infusion. According to catheterization after the second urine specimens are detected in red blood cells to adjudicate whether the urethral mucosal injury， B， C groups after extubation to take urine bacterial culture， the number of bacteria in urine ≥ 105 / L， that is， urinary tract infection . Results A， B group differences in rates of urinary tract mucosal injury in group B was significantly lower than group A (P<0.05)； B， C group after extubation differences in rates of urinary tract infection in group C was significantly lower than group B， P<0.01 (χ2= 16.175). Conclusion： The combined anesthesia catheter is placed after the best period of urethral catheterization can reduce mucosal damage； 12h after removal of the end of the infusion catheter to prevent retrograde bacterial infection and urinary retention play a positive role， is catheter removal tube the best time.
【Key words】 Cesarean section； Catheter； Indwelling catheter
留置导尿是剖宫产手术前的常规准备，目的是排空膀胱以免手术中误伤，同时有利于观察尿量及肾功能。一般情况下，此项操作属术前准备内容，由病房护士执行[1] ......
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