大面积吸脂术后尿潴留的护理体会(1)
[摘要]目的：探讨大面积吸脂术后尿潴留(Postoperative urinary retention， PUR)的有效护理与处置方法。方法：对本院2017年1月-2017年10月全麻下行大面积吸脂手术和术后给予静脉镇痛的100例就医者资料进行回顾性研究。其中15例发生术后尿潴留，行理疗和α1受体阻滞剂联合治疗，无效则行导尿术。无1例行膀胱造瘘。结果：所有患者都恢复了自主排尿，15例术后尿潴留得到解除，留置导尿12～48h，13例临床实验性拔管成功，2例失败再次插管，同时辅以α1受体阻滞剂，6h后拔出。结论：本次护理方法对大面积吸脂术后尿潴留就医者具有有效、安全、耐受性好等优点，能改善不适的下尿路症状，降低PUR和PUR相关疾病风险。
[关键词]术后尿潴留；护理；治疗；大面积；吸脂术
[中图分类号]R47 [文献标志码]B [文章编号]1008-6455(2018)05-0144-03
, 百拇医药 The Nursing Experience of Postoperative Urinary Retention in Large Area Liposuction
TAO Fen-lan1，TANG An2，ZHANG Xia1，HU Xiao-yan1，LIU Yan-qun1
(1.Department of Nursing；2.Department of Anesthesiology，Nanjing Medical University Friendship Plastic Surgery Hospital，Nanjing 210029，Jiangsu，China)
Abstract： Objective To present our experience of managing and nursed postoperative urinary retention (PUR) in large area liposuction. Methods This is a retrospective review of 100 inpatients with large area liposuction from January 2017 to October 2017. All patients received general anesthesia duration and postoperative analgesia. Postoperative urinary retention in 15 patients， the management included physical therapy， drug treatments with α1 receptor blockers， and urethral catheterization was performed when treatment is not effective. None of patients were used cystostomy. Results All patients recovered their own urination. The 15 patients with PUR were relieved after combination therapy and required straight catheterization 12-48h. The success of clinical experimental extubation (TWOC) in 13 patients， two patients were failure， need to be inserted again and combined α1 receptor blockers， urinary catheters were removed again after 6h. Conclusion This management is an effective， safe and well-tolerated treatment of PUR in large area liposuction and improve symptoms， reduce the risk of PUR and risk for PUR-related disease.
, 百拇医药
Key words： postoperative urinary retention(PUR)； nursed； treatment； large area； liposuction
整形美容求術者除了对充满人情味的就医环境和服务举措有强烈要求外，还希望享受舒适、无痛苦的诊疗过程。随着无痛技术的广泛应用，美容求术者对术中无痛麻醉技术和术后基本无痛的镇痛技术非常满意，但无痛技术术后出现的尿潴留(Postoperative urinary retention，PUR)等并发症可产生不适、焦虑等不良情绪[1-3]。笔者科室从2017年1月-2017年10月对大面积吸脂术后尿潴留者进行了有效护理与处置，现报道如下。
1 临床资料
本组100例大面积吸脂术者，均在全麻下手术，吸脂部位为腰腹臀上、双大腿，吸脂量6 000ml以上。麻醉清醒后(术后4h以上)15例(年龄21～61岁，平均27岁，均为女性)出现尿意窘迫，欲尿不出，下腹满闷胀痛，辗转不安，并伴有对手术和生命安全的焦虑及恐惧。检查膀胱区隆起，叩诊为浊音。求术者全部无泌尿系统疾患史。术前均行各项常规检查，未发现有糖尿病等内分泌疾患，无肾功能、尿常规异常，X片和B超检查也无尿道、膀胱的结石和占位性病变。经规范尿潴留处置后首次排尿量均在500～1 000ml。
2 方法
所有受术者术毕拨管后从麻醉复苏室转入病房监护，常规给予静脉镇痛泵止痛。根据受术者术后疼痛情况适当追加杜冷丁或曲马多等止痛剂。心电监护监测基本生命体征(呼吸、脉博、血压、氧饱和度、心电图)，一旦出现排尿困难或尿潴留，立即采用下列护理措施处置：, 百拇医药(陶粉兰 唐安 张霞 呼晓燕 刘燕群)
[关键词]术后尿潴留；护理；治疗；大面积；吸脂术
[中图分类号]R47 [文献标志码]B [文章编号]1008-6455(2018)05-0144-03
, 百拇医药 The Nursing Experience of Postoperative Urinary Retention in Large Area Liposuction
TAO Fen-lan1，TANG An2，ZHANG Xia1，HU Xiao-yan1，LIU Yan-qun1
(1.Department of Nursing；2.Department of Anesthesiology，Nanjing Medical University Friendship Plastic Surgery Hospital，Nanjing 210029，Jiangsu，China)
Abstract： Objective To present our experience of managing and nursed postoperative urinary retention (PUR) in large area liposuction. Methods This is a retrospective review of 100 inpatients with large area liposuction from January 2017 to October 2017. All patients received general anesthesia duration and postoperative analgesia. Postoperative urinary retention in 15 patients， the management included physical therapy， drug treatments with α1 receptor blockers， and urethral catheterization was performed when treatment is not effective. None of patients were used cystostomy. Results All patients recovered their own urination. The 15 patients with PUR were relieved after combination therapy and required straight catheterization 12-48h. The success of clinical experimental extubation (TWOC) in 13 patients， two patients were failure， need to be inserted again and combined α1 receptor blockers， urinary catheters were removed again after 6h. Conclusion This management is an effective， safe and well-tolerated treatment of PUR in large area liposuction and improve symptoms， reduce the risk of PUR and risk for PUR-related disease.
, 百拇医药
Key words： postoperative urinary retention(PUR)； nursed； treatment； large area； liposuction
整形美容求術者除了对充满人情味的就医环境和服务举措有强烈要求外，还希望享受舒适、无痛苦的诊疗过程。随着无痛技术的广泛应用，美容求术者对术中无痛麻醉技术和术后基本无痛的镇痛技术非常满意，但无痛技术术后出现的尿潴留(Postoperative urinary retention，PUR)等并发症可产生不适、焦虑等不良情绪[1-3]。笔者科室从2017年1月-2017年10月对大面积吸脂术后尿潴留者进行了有效护理与处置，现报道如下。
1 临床资料
本组100例大面积吸脂术者，均在全麻下手术，吸脂部位为腰腹臀上、双大腿，吸脂量6 000ml以上。麻醉清醒后(术后4h以上)15例(年龄21～61岁，平均27岁，均为女性)出现尿意窘迫，欲尿不出，下腹满闷胀痛，辗转不安，并伴有对手术和生命安全的焦虑及恐惧。检查膀胱区隆起，叩诊为浊音。求术者全部无泌尿系统疾患史。术前均行各项常规检查，未发现有糖尿病等内分泌疾患，无肾功能、尿常规异常，X片和B超检查也无尿道、膀胱的结石和占位性病变。经规范尿潴留处置后首次排尿量均在500～1 000ml。
2 方法
所有受术者术毕拨管后从麻醉复苏室转入病房监护，常规给予静脉镇痛泵止痛。根据受术者术后疼痛情况适当追加杜冷丁或曲马多等止痛剂。心电监护监测基本生命体征(呼吸、脉博、血压、氧饱和度、心电图)，一旦出现排尿困难或尿潴留，立即采用下列护理措施处置：, 百拇医药(陶粉兰 唐安 张霞 呼晓燕 刘燕群)
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