目的探讨地佐辛对全身麻醉术后导尿管相关性膀胱刺激征（Catheter Related Badder Discomfort，CRBD）的预防价值。方法选取2014年2月至2016年5月期间本院收治的全麻腹腔镜下胆囊切除术患者68例，所有患者均需留置导尿管。按照是否预防...目的探讨地佐辛对全身麻醉术后导尿管相关性膀胱刺激征（Catheter Related Badder Discomfort，CRBD）的预防价值。方法选取2014年2月至2016年5月期间本院收治的全麻腹腔镜下胆囊切除术患者68例，所有患者均需留置导尿管。按照是否预防性应用地佐辛将其分为观察组和对照组，两组患者均在全麻诱导后插入导尿管。在手术结束前20min，观察组患者取地佐辛0．1mg／kg静脉推注，对照组患者则取0．9％氯化钠0．05ml／kg静脉推注，对两组患者拔管后不同时间点膀胱刺激征的发生情况及严重程度等进行观察分析。结果观察组患者的CRBD发生率及严重程度均明显低于对照组，差异有统计学意义（P〈0．05）；观察组患者在拔管后不同时刻Riker镇静一躁动评分均明显低于对照组，差异有统计学意义（P〈0．05）。结论对于全身麻醉留置导尿管患者，在手术结束前20min给予患者地佐辛静推可有效降低CRBD的发生风险，对于减轻患者痛苦，促进其术后顺利恢复具有十分积极的意义，建议在临床进一步推广应用。展开更多
The aim of this study was to figure out the predictors of early postoperative catheter-related bladder discomfort（CRBD） after urological surgery. We designed a prospective observational study in our hospital. Consec...The aim of this study was to figure out the predictors of early postoperative catheter-related bladder discomfort（CRBD） after urological surgery. We designed a prospective observational study in our hospital. Consecutive adult patients undergoing surgery under general anaesthesia or epidural anaesthesia necessitating urinary catheterization were included during a 3-month period. severity of bladder discomfort was assessed on a 4-point scale：（1） no pain,（2） mild pain（revealed only by interviewing the patient）,（3） moderate（a spontaneous complaint by the patient of a burning sensation in the urethra and/or an urge to urinate and/or sensation of urethral foreign body without any emotional agitation） and（4） severe discomfort（agitation, loud complaints and attempt to remove the bladder catheter associated with a burning sensation in the urethra）. Predictors of CRBD were identified by univariate and multivariate analysis. Totally, 116 patients were included, of which 84.5% had CRBD（mild CRBD： 40.5%; moderate or severe CRBD： 44.0%） at day 1, while 31.9% developed CRBD（mild CRBD： 29.3%; moderate or severe CRBD： 2.6%） at day 3. We evaluated 9 potential forecast factors of CRBD, and univariate Chi-square test showed male gender [OR=2.4, 95%CI（1.1–5.6）, P〈0.05], abdominal open surgery compared with transurethral surgery [OR=0.3, 95%CI（0.1–0.6）, P〈0.05], abdominal surgery compared with laparoscopic surgery [OR=3.3, 95%CI（1.2–8.9）, P〈0.05] and history of catheterization [OR=0.5, 95%CI（0.2–0.9）, P〈0.05] were independent predictors of moderate or severe CRBD in the patients after surgery. While multivariate logistic regression analysis showed that the abdominal open surgery [EXP（B）=3.074, 95%CI（1.3–7.4）, P〈0.05] and the history of catheterization [EXP（B）=2.458, 95%CI（1.1–5.9）, P〈0.05] might contribute more to the occurrence of moderate or severe CRBD. In conclusion, this observational study identified that the type of surger展开更多
文摘目的探讨地佐辛对全身麻醉术后导尿管相关性膀胱刺激征（Catheter Related Badder Discomfort，CRBD）的预防价值。方法选取2014年2月至2016年5月期间本院收治的全麻腹腔镜下胆囊切除术患者68例，所有患者均需留置导尿管。按照是否预防性应用地佐辛将其分为观察组和对照组，两组患者均在全麻诱导后插入导尿管。在手术结束前20min，观察组患者取地佐辛0．1mg／kg静脉推注，对照组患者则取0．9％氯化钠0．05ml／kg静脉推注，对两组患者拔管后不同时间点膀胱刺激征的发生情况及严重程度等进行观察分析。结果观察组患者的CRBD发生率及严重程度均明显低于对照组，差异有统计学意义（P〈0．05）；观察组患者在拔管后不同时刻Riker镇静一躁动评分均明显低于对照组，差异有统计学意义（P〈0．05）。结论对于全身麻醉留置导尿管患者，在手术结束前20min给予患者地佐辛静推可有效降低CRBD的发生风险，对于减轻患者痛苦，促进其术后顺利恢复具有十分积极的意义，建议在临床进一步推广应用。
文摘The aim of this study was to figure out the predictors of early postoperative catheter-related bladder discomfort（CRBD） after urological surgery. We designed a prospective observational study in our hospital. Consecutive adult patients undergoing surgery under general anaesthesia or epidural anaesthesia necessitating urinary catheterization were included during a 3-month period. severity of bladder discomfort was assessed on a 4-point scale：（1） no pain,（2） mild pain（revealed only by interviewing the patient）,（3） moderate（a spontaneous complaint by the patient of a burning sensation in the urethra and/or an urge to urinate and/or sensation of urethral foreign body without any emotional agitation） and（4） severe discomfort（agitation, loud complaints and attempt to remove the bladder catheter associated with a burning sensation in the urethra）. Predictors of CRBD were identified by univariate and multivariate analysis. Totally, 116 patients were included, of which 84.5% had CRBD（mild CRBD： 40.5%; moderate or severe CRBD： 44.0%） at day 1, while 31.9% developed CRBD（mild CRBD： 29.3%; moderate or severe CRBD： 2.6%） at day 3. We evaluated 9 potential forecast factors of CRBD, and univariate Chi-square test showed male gender [OR=2.4, 95%CI（1.1–5.6）, P〈0.05], abdominal open surgery compared with transurethral surgery [OR=0.3, 95%CI（0.1–0.6）, P〈0.05], abdominal surgery compared with laparoscopic surgery [OR=3.3, 95%CI（1.2–8.9）, P〈0.05] and history of catheterization [OR=0.5, 95%CI（0.2–0.9）, P〈0.05] were independent predictors of moderate or severe CRBD in the patients after surgery. While multivariate logistic regression analysis showed that the abdominal open surgery [EXP（B）=3.074, 95%CI（1.3–7.4）, P〈0.05] and the history of catheterization [EXP（B）=2.458, 95%CI（1.1–5.9）, P〈0.05] might contribute more to the occurrence of moderate or severe CRBD. In conclusion, this observational study identified that the type of surger
