Research status of no-urinary catheterization in post-spineoperative patients under the enhanced recovery after surgery mode_West China Medical Journal

Authors：

ZHONG Shangjie ,  NING Ning , LI Peifang , CHEN Jiali , YAO Mei , LUO Xiaoling

Department of Orthopedics, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

NING Ning, Email: gkningning@126.com

Keywords：

Enhanced recovery after surgery; Spine surgery; Urination; Influenced factors

DOI：

10.7507/1002-0179.201904059

Video：

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Objective To investigate the status of urination in post-spineoperative (cervical thoracic and lumber verteb) patients under the enhanced recovery after surgery (ERAS) mode.Methods Patients who were admitted to the West China Hospital of Sichuan University from October 2018 to February 2019 were enrolled. The urination status of the patients was collected by using questionnaires. All patients were divided into normal urinating group, induced urinating group and catheterization group according to their urination status after returning to the ward.Results A total of 106 patients were included, including 78 (73.6%) who urinated smoothly [the first urinating time (72.18±36.33) min], 20 (18.9%) who urinated after induction [the first urinating time (81.50±41.68) min], and 8 (7.5%) who received catheters after induction failure [the first urinating time (162.50±84.52) min]. The different operation, operation time, position of urination, and postoperative pain degree affecting the placement of urethral catheter differed from each other significantly (P<0.05). Among the three groups, the differences were statistically significant in operation time, operation methods, position of urination (except for the induced urination group vs. catheterization group) and postoperative pain degree (except for the induced urination group vs. catheterization group) in pairs (P<0.05). There was no significant difference in other factors among three groups in pairs (P>0.05).Conclusions Most post-spineoperative patients can autonomously urinate without catheter under the ERAS mode, which bases on operation methods, operation time, and the first urinating posture after the surgery. Early attention should be paid to patients with dysuresia to promote their early rehabilitation.

Citation： ZHONG Shangjie, NING Ning, LI Peifang, CHEN Jiali, YAO Mei, LUO Xiaoling. Research status of no-urinary catheterization in post-spineoperative patients under the enhanced recovery after surgery mode. West China Medical Journal, 2020, 35(7): 851-854. doi: 10.7507/1002-0179.201904059 Copy

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10.	李伟, 兰彬, 范娟. 全身麻醉下介入治疗低级别颅内动脉瘤术前不留置尿管的可行性研究. 华西医学, 2013, 28(1): 112-113.
11.	吴孟航, 陈茂君, 刘闻捷. 加速康复外科模式下 Chiari 畸形患者围术期无尿管留置的效果研究. 四川大学学报(医学版), 2018, 49(4): 670-672.
12.	詹瑜佳, 陈佳丽, 陈潇, 等. 不留置尿管在全膝关节置换术后对患者排尿影响的研究. 护士进修杂志, 2014, 29(22): 2027-2028.
13.	朱诗白, 翟洁, 蒋超, 等. 膝关节置换围手术期的快速康复措施. 中国组织工程研究, 2017, 21(3): 456-463.
14.	余洋, 谭彪, 杨世鹏, 等. 经皮内镜可视化椎间孔成形技术治疗腰椎间盘突出症. 中国微创外科杂志, 2018, 18(9): 779-782, 786.
15.	国家卫生计生委公益性行业科研专项《关节置换术安全性与效果评价》项目组, 中华医学会骨科学分会关节外科学组, 中国医疗保健国际交流促进会骨科分会关节外科委员会. 中国髋、膝关节置换术加速康复—围术期管理策略专家共识. 中华骨与关节外科杂志, 2016, 9(1): 1-9.
16.	黄丽亚. 术前排尿训练对骨科手术后患者排尿影响分析. 护士进修杂志, 2005, 20(2): 132-133.
17.	贺立新, 孙小晶, 蒋珍凤, 等. 平卧位排尿训练对腰椎间盘突出症患者术后排尿方式的影响. 护士进修杂志, 2011, 26(16): 1448-1449.

1. Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth, 1997, 78(5): 606-617.
2. 张德娟, 张晓岚, 寇贤丽. 改良尿管拔除模式对拔管后尿潴留及排尿舒适度的影响. 西北国防医学杂志, 2017, 38(9): 598-601.
3. 杨宇莹, 蒋琳, 曹静. 脊柱手术住院患者术后泌尿系统感染的病原学特征和危险因素分析. 中国医学前沿杂志(电子版), 2018, 10(11): 120-123.
4. 雷一霆, 黄强, 张少云, 等. 人工全髋关节置换术围术期限制性输液联合术前排尿训练的临床研究. 中国修复重建外科杂志, 2017, 31(11): 1295-1299.
5. 孙天胜, 沈建雄, 刘忠军, 等. 中国脊柱手术加速康复—围术期管理策略专家共识. 中华骨与关节外科杂志, 2017, 10(4): 271-279.
6. 米爽, 洪正华, 王美珍, 等. 减少脊柱手术术中出血措施的研究进展. 中国脊柱脊髓杂志, 2016, 26(1): 86-89.
7. 屈俊宏, 宁宁, 李佩芳, 等. 脊柱外科入院患者情绪障碍调查研究. 华西医学, 2017, 32(9): 1347-1350.
8. 刘伟, 林汉生. SPSS 在完全随机设计多个样本间多重比较 Nemenyi 秩和检验中的应用. 中国卫生统计, 2009, 26(2): 214, 216.
9. 文守琴, 李玲利, 陈佳丽, 等. 全膝关节置换术不安置尿管的可行性研究. 华西医学, 2014, 29(12): 2342-2343.
10. 李伟, 兰彬, 范娟. 全身麻醉下介入治疗低级别颅内动脉瘤术前不留置尿管的可行性研究. 华西医学, 2013, 28(1): 112-113.
11. 吴孟航, 陈茂君, 刘闻捷. 加速康复外科模式下 Chiari 畸形患者围术期无尿管留置的效果研究. 四川大学学报(医学版), 2018, 49(4): 670-672.
12. 詹瑜佳, 陈佳丽, 陈潇, 等. 不留置尿管在全膝关节置换术后对患者排尿影响的研究. 护士进修杂志, 2014, 29(22): 2027-2028.
13. 朱诗白, 翟洁, 蒋超, 等. 膝关节置换围手术期的快速康复措施. 中国组织工程研究, 2017, 21(3): 456-463.
14. 余洋, 谭彪, 杨世鹏, 等. 经皮内镜可视化椎间孔成形技术治疗腰椎间盘突出症. 中国微创外科杂志, 2018, 18(9): 779-782, 786.
15. 国家卫生计生委公益性行业科研专项《关节置换术安全性与效果评价》项目组, 中华医学会骨科学分会关节外科学组, 中国医疗保健国际交流促进会骨科分会关节外科委员会. 中国髋、膝关节置换术加速康复—围术期管理策略专家共识. 中华骨与关节外科杂志, 2016, 9(1): 1-9.
16. 黄丽亚. 术前排尿训练对骨科手术后患者排尿影响分析. 护士进修杂志, 2005, 20(2): 132-133.
17. 贺立新, 孙小晶, 蒋珍凤, 等. 平卧位排尿训练对腰椎间盘突出症患者术后排尿方式的影响. 护士进修杂志, 2011, 26(16): 1448-1449.

West China Medical Journal

Research status of no-urinary catheterization in post-spineoperative patients under the enhanced recovery after surgery mode

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