妇科日间单孔腹腔镜手术中不安置导尿管的效果研究

Efficacy of gynecological single-port laparoscopic surgery without placing catheters in the daytime

  • 摘要:
      目的  探讨妇科日间单孔腹腔镜手术中不安置导尿管的有效性及安全性。
      方法  选取妇科日间手术病区收治的腹腔镜手术患者129例,随机分为观察组59例,术中不安置导尿管;对照组70例,手术中安置导尿管,手术结束时拔除。手术均采用单孔腹腔镜技术。比较2组术后主要结局指标尿路刺激征发生率、次要结局指标尿路感染率、尿潴留发生率、膀胱损伤发生率及首次下床时间、首次排气时间、首次排尿时间。
      结果  观察组术后尿路刺激征发生率8.47%,低于对照组的21.43%,差异有统计学意义(P < 0.05);2组术后首次下床时间、排尿时间及排气时间比较,差异无统计学意义(P>0.05)。2组均无尿潴留、泌尿系感染及膀胱损伤等情况发生。
      结论  针对卵巢囊肿剥除、子宫肌瘤剥除及输卵管相关的妇科日间单孔腹腔镜手术,术中不安置导尿管安全有效,并可降低术后尿路刺激征的发生率。

     

    Abstract:
      Objective  To explore the efficacy and safety of gynecological single-port laparoscopic surgery without placing catheters in the daytime.
      Methods  A total of 129 patients with laparoscopic surgery in the Ward of Gynecological Daytime Operation were selected and randomly divided into observation group (n=59) without placing catheters and control group (n=70) with placing catheters during operation and removing catheters at the end of operation. Single-port laparoscopic technique was adopted in all the operations. The incidence of urinary irritation symptoms (the main outcome indicator) and secondary outcome indicators such as urinary tract infection rate, urinary retention rate, incidence of bladder injury, time to first getting out of bed, time to first exhaust and time to first urination were compared between two groups.
      Results  The incidence of postoperative urinary irritation symptoms in the observation group was 8.47%, which was significantly lower than 21.43% in the control group (P < 0.05). There were no significant differences in the time to first getting out of bed, time to first exhaust and time to first urination between the two groups (P>0.05). No urinary retention, urinary tract infection and bladder injury were observed in both groups.
      Conclusion  In the gynecological single-port laparoscopic surgery in the daytime for exfoliation of ovarian cyst, exfoliation of hysteromyoma and fallopian tube related diseases, it is safe and effective to not to place catheters during operation, which can reduce the incidence of postoperative urinary tract irritation.

     

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