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中华老年病研究电子杂志 ›› 2021, Vol. 08 ›› Issue (04) : 18 -21. doi: 10.3877/cma.j.issn.2095-8757.2021.04.005

老年骨科疾病

椎管内麻醉下接受髋关节置换术的老年男性患者行侧卧位导尿效果分析
张治明1, 李君玲1, 肖勋刚2, 周毅2, 邹康2, 赵昀2,()   
  1. 1. 423000 郴州,南华大学衡阳医学院附属郴州医院(郴州市第一人民医院)麻醉科
    2. 423000 郴州,南华大学衡阳医学院附属郴州医院(郴州市第一人民医院)关节外科
  • 收稿日期:2021-04-08 出版日期:2021-11-28
  • 通信作者: 赵昀
  • 基金资助:
    湖南省自然科学基金项目(2019JJ40010); 郴州市科学发展计划项目(ZDYF2020041)

Effect of lateral catheterization in elderly male patients undergoing hip arthroplasty under intrathecal anesthesia

Zhiming Zhang1, Junlin Li1, Xungang Xiao2, Yi Zhou2, Kang Zou2, Yun Zhao2,()   

  1. 1. Department of Anesthesiology, the First People's Hospital of Chenzhou, Chenzhou 423000, China
    2. Joint Surgery, the First People's Hospital of Chenzhou, Chenzhou 423000, China
  • Received:2021-04-08 Published:2021-11-28
  • Corresponding author: Yun Zhao
引用本文:

张治明, 李君玲, 肖勋刚, 周毅, 邹康, 赵昀. 椎管内麻醉下接受髋关节置换术的老年男性患者行侧卧位导尿效果分析[J]. 中华老年病研究电子杂志, 2021, 08(04): 18-21.

Zhiming Zhang, Junlin Li, Xungang Xiao, Yi Zhou, Kang Zou, Yun Zhao. Effect of lateral catheterization in elderly male patients undergoing hip arthroplasty under intrathecal anesthesia[J]. Chinese Journal of Geriatrics Research(Electronic Edition), 2021, 08(04): 18-21.

目的

探讨腰麻下接受髋关节置换的老年男性患者行侧卧位导尿的可行性。

方法

选取2018年3月至2019年3月郴州市第一人民医院收治的腰麻下接受髋关节置换术的老年男性患者65例,均于侧卧位完成轻比重腰麻后保持体位不变实施导尿。根据导尿操作次数的不同分为尝试期、熟悉期、熟练期。记录手术医师对侧卧位导尿操作的便利性评分、导尿用时、导尿成功率,以及导尿时的患者疼痛评分。多组间计量资料的比较采用方差分析。

结果

所有患者均在10 min内成功完成导尿术,导尿过程中无患者主诉有痛苦和不适感,导尿时间1~10(5.5±2.1)min。医师导尿操作便利性评分为2~9(5.5±1.7)分。患者疼痛评分1~3(1.3±0.7)分。导尿医师不同时期导尿时间、操作便利性评分的差异均有统计学意义(F=7.5000、18.9000,P<0.05);与尝试期比较,熟悉期和熟练期导尿时间均明显缩短、操作便利性评分均明显增加(P<0.05);与熟悉期比较,熟练期操作便利性评分明显增加(P<0.05)。

结论

腰麻下接受髋关节置换术的老年男性患者在侧卧位下可以顺利实施导尿术,随着术者导尿操作次数的增加,导尿时间会明显缩短、操作便利性会明显提高。

Objective

To investigate the feasibility of lateral decubitus catheterization in elderly male patients undergoing hip arthroplasty under intrathecal anesthesia.

Methods

65 elderly male patients who received hip arthroplasty under intrathecal anesthesia from March 2018 to March 2019 in the First People's Hospital of Chenzhou were selected. All of them completed light specific intrathecal anesthesia in lateral decubitus and kept the same position for catheterization. According to the different times of catheterization operation, it can be divided into trial period, familiar period and skilled period. The convenience score, duration of catheterization, success rate of catheterization and pain score of patients during catheterization were recorded. Analysis of variance was used for comparingthe difference of measurement data.

Results

All patients were successfully catheterized within 10 min, no patients complained of pain and discomfort during the catheterization process. The catheterization time was 1~10 (5.5±2.1) min. The convenience score of catheterization was 2~9 (5.5±1.7). The pain score was 1~3 (1.3±0.7). There were significant differences in catheterization time and operation convenience scores among catheterizers in different periods (F=7.500, 18.900, P < 0.05). Compared with the trial period, the catheterization time was significantly shortened and the operation convenience score was significantly increased in the familiar period and skilled period (P < 0.05); Compared with the familiar period, the operation convenience score in the skilled period increased significantly (P < 0.05).

Conclusion

Elderly male patients undergoing hip arthroplasty under intrathecal anesthesia can successfully perform catheterization in the lateral position. With the increase of the number of catheterization operations, the catheterization time will be significantly shortened and the convenience of operation will be significantly improved.

图1 侧卧位导尿实施案例。1A为消毒完毕开始导尿;1B为导尿成功后液囊注水;1C为导尿完成
表1 导尿医师不同时期导尿时间、操作便利性评分以及患者疼痛评分的比较
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