摘要
目的探究颅内动脉瘤患者介入治疗术不留置导尿管的效果及安全性。方法选取2022年6月至2023年4月于四川大学华西医院神经外科住院介入治疗的颅内动脉瘤患者共173例,采用自然分组法,其中医疗组A为试验组,共87例,医疗组B为对照组,共86例。试验组术中不留置尿管,对照组术中留置尿管并在术后次日晨间遵医嘱拔出。主要观察指标为术后尿潴留发生率,次要观察指标为尿路刺激征、尿路感染、尿道损伤、病房导尿管置管、非计划拔管、术后躁动、动脉瘤破裂出血和穿刺部位血肿/出血的发生率。采用χ^(2)检验进行试验组和对照组组间上述指标的差异比较,采用相对危险度(RR)值计算2组发生率之比。结果与对照组相比,试验组术后尿潴留发生率下降(5.62%vs 18.39%,χ^(2)=6.830,P=0.009),仅为对照组的0.309倍(RR=0.309,95.0%CI:1.241~8.446,P=0.016),尿路刺激征发生率低于对照组(0 vs 13.79%,χ^(2)=14.829,P<0.001),是对照组的0.040倍(RR=0.040,95%CI:0.002~0.658,P=0.024)。2组其他并发症和负性事件指标的差异均无统计学意义(P>0.05)。结论术中不留置导尿管可以降低颅内动脉瘤介入治疗术患者术后尿潴留、尿路刺激征的发生率,不增加术后动脉瘤破裂出血和穿刺部位血肿/出血的发生率,具有一定的安全性和可行性。
Objective To explore the effect and safety of no indwelling catheter after interventional therapy in patients with intracranial aneurysms.Methods A total of 173 patients with intracranial aneurysms hospitalized in our department from June 2022 to April 2023 were included.They were divided into two groups by natural grouping method,including 87 cases in the medical group A as the experimental group and 86 cases in the medical group B as the control group.The experimental group did not retain a catheter during the operation,while the control group retained a catheter during the operation and pulled it out in the next morning after the operation,according to the doctor's advice.The primary outcome was the incidence of postoperative urinary retention.The secondary outcomes were the incidence of urinary tract irritation,urinary tract infection,urethral injury,indwelling rate of catheter in the ward,unplanned extubation,postoperative agitation,aneurysm rupture,and hematoma/hemorrhage at puncture site.The Chi-square test was used to compare the differences in the above indexes between the two groups.Relative ratio(RR)was used to calculate the incidence ratio of the two groups.Results Compared with the control group,the incidence of postoperative urinary retention in the experimental group decreased(5.62%vs 18.39%,χ^(2)=6.830,P=0.009),which was only 0.309 times lower than that in the control group(RR=0.309,95.0%CI:1.241-8.446,P=0.016),and the incidence of urinary tract irritation in the experimental group was lower than that in the control group(0 vs 13.79%,χ^(2)=14.829,P<0.001),which was 0.040 times lower than that in the control group(RR=0.040,95%CI:0.002-0.658,P=0.024).There was no significant difference in other complications and adverse events.Conclusion No indwelling catheter during operation can reduce the incidence of postoperative urinary retention and urinary tract irritation in patients with intracranial aneurysms undergoing interventional embolization,and does not increase the incidence of postoperative aneurysm rupture bleeding and hematoma/hemorrhage at the puncture site.It is safe,feasible,and worth promoting.
作者
段丽娟
蒋艳
樊朝凤
曹华
Duan Lijuan;Jiang Yan;Fan Chaofeng;Cao Hua(Department of Neurosurgery,West China Hospital,Sichuan University,Chengdu 610041,China;West China School of Nursing,Sichuan University,Chengdu 610041,China;Department of Nursing,West China Hospital,Sichuan University,Chengdu 610041,China)
出处
《中华脑血管病杂志（电子版）》
2024年第2期104-109,共6页
Chinese Journal of Cerebrovascular Diseases(Electronic Edition)
关键词
颅内动脉瘤
介入治疗
导尿管
加速康复
Intracranial aneurysm
Endovascular therapy
Urinary catheter
Enhanced recovery after surgery
