Pulmonary perioperative catheter management strategy: aprospective cohort study

doi:10.3877/cma.j.issn.2095-8773.2017.03.08

Abstract

Abstract:

Objective

To explore the management strategy of urinary perioperative catheter in Enhanced Recovery After Surgery (ERAS) practice.

Methods

A total of 45 patients underwent thoracoscopic surgery (VATS) with lobectomy in the General Hospital of Zhejiang University Medical College from March to May in 2017. The patients were divided into control group (n=21) and experimental group (n=24). The two group’s indicators of intraoperative (operation time, infusion volume and bleeding volume) and postoperative(Urinary retention, urinary incontinence and urinary tract infection incidence and comfort, time to get out of bed and average hospital stay) were observed and compared.

Results

There was no statistical significant difference between the two groups in the basic data operation time and intraoperative infusion volume (P>0.05). However, the blood loss in the control group was significantly higher than that in the experimental group, the difference was statistically significant [(83 ± 29) ml vs (60 ± 19) ml, P = 0.003]. There was no urinary retention in the two groups, and the incidence of urinary incontinence, urinary tract infection and time of getting out of bed were not statistically significant (P>0.05). The incidence of urinary tract irritation was significantly lower in the experimental group than that in the control group (16.7% vs 47.6%, P=0.025; 87.5% vs 42.9%, P=0.002). The proportion of patients with urethral symptoms was significantly lower than that of the control group (12.5% vs 52.4%, P= 0.002), and the average hospitalization time was significantly higher than that of the control group (5.0±1.6) d vs (6.3±2.1) d, P=0.021].

Conclusions

Urinary retention and urinary incontinence are not increased for the experimental group and the number of days of hospitalization can be shortened, and the postoperative comfort and rapid rehabilitation can be improved.

Key words: Enhanced recovery after surgery, Indwelling urethral catheters, Catheter management, Lobectomy

Pinghui Xia, Jieping Zhang, Yihe Wu, Chong Zhang, Jun Cheng, Wang Lyu, Jian Hu. Pulmonary perioperative catheter management strategy: aprospective cohort study[J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2017, 04(03): 171-176.

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Figures/Tables 5

References 22

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项目		对照组(n＝21)	实验组(n＝24)	检验值	P值	项目		对照组(n＝21)	实验组(n＝24)	检验值	P值
平均年龄(岁，±s)		52.0± 8.7	49.4±9.1	t＝0.987	0.329	前列腺增生		?	?	?	?
性别		?	?	χ²＝0.060	0.807	?	是	0(0)	0(0)	?	?
?	男性	8(38.1)	10(41.7)	?	?	?	否	21(100)	24(100)	?	?
?	女性	13(61.9)	14(58.3)	?	?	病理类型		?	?	χ²＝0.979	0.322
糖尿病		?	?	χ²＝0.517	0.472	?	肺癌	16(76.2)	15(62.5)	?	?
?	是	6(28.6)	5(20.8)	?	?		肺良性肿瘤	5(23.8)	9(37.5)	?	?
?	否	15(71.4)	19(79.2)	?	?	手术方式		?	?	?	?
高血压		?	?	χ²＝0.363	0.547	?	VATS	21(100)	24(100)	?	?
?	是	2(9.5)	2(8.3)	?	?	?	开胸	0(0)	0(0)	?	?
?	否	19(90.5)	22(91.7)	?	?	TNM分期¹		?	?	χ²＝2.100	0.350
心脏病		?	?	χ²＝1.169	0.280	?	Ⅰ期	14(87.5)	14(93.3)	?	?
?	是	1(4.8)	0(0)	?	?	?	Ⅱ～Ⅲ期	2(12.5)	1(6.7)	?	?
?	否	20(95.2)	24(100)	?	?	?		?	?	?	?

项目		对照组(n＝21)	实验组(n＝24)	检验值	P值	项目		对照组(n＝21)	实验组(n＝24)	检验值	P值
平均年龄(岁，±s)		52.0± 8.7	49.4±9.1	t＝0.987	0.329	前列腺增生		?	?	?	?
性别		?	?	χ²＝0.060	0.807	?	是	0(0)	0(0)	?	?
?	男性	8(38.1)	10(41.7)	?	?	?	否	21(100)	24(100)	?	?
?	女性	13(61.9)	14(58.3)	?	?	病理类型		?	?	χ²＝0.979	0.322
糖尿病		?	?	χ²＝0.517	0.472	?	肺癌	16(76.2)	15(62.5)	?	?
?	是	6(28.6)	5(20.8)	?	?		肺良性肿瘤	5(23.8)	9(37.5)	?	?
?	否	15(71.4)	19(79.2)	?	?	手术方式		?	?	?	?
高血压		?	?	χ²＝0.363	0.547	?	VATS	21(100)	24(100)	?	?
?	是	2(9.5)	2(8.3)	?	?	?	开胸	0(0)	0(0)	?	?
?	否	19(90.5)	22(91.7)	?	?	TNM分期¹		?	?	χ²＝2.100	0.350
心脏病		?	?	χ²＝1.169	0.280	?	Ⅰ期	14(87.5)	14(93.3)	?	?
?	是	1(4.8)	0(0)	?	?	?	Ⅱ～Ⅲ期	2(12.5)	1(6.7)	?	?
?	否	20(95.2)	24(100)	?	?	?		?	?	?	?

组别	术中输液量(ml)	手术时间(min)	术中失血量(ml)
对照组(n＝21)	1 261±340	89±23	83±29
实验组(n＝24)	1 093±311	91±32	60±19
t值	1.722	－0.280	3.167
P值	0.093	0.776	0.003

组别	术中输液量(ml)	手术时间(min)	术中失血量(ml)
对照组(n＝21)	1 261±340	89±23	83±29
实验组(n＝24)	1 093±311	91±32	60±19
t值	1.722	－0.280	3.167
P值	0.093	0.776	0.003

项目		对照组(n＝21)	实验组(n＝24)	χ²值	P值
尿潴留		?	?	?	?
?	是	0(0)	0(0)	?	?
?	否	21(100)	24(100)	?	?
尿路感染		?	?	2.813	0.094
?	是	14(66.7)	10(41.7)	?	?
?	否	7(33.3)	14(58.3)	?	?
尿失禁		?	?	0.517	0.472
?	是	2(9.5)	1(4.2)	?	?
?	否	19(90.5)	23(95.8)	?	?
尿道刺激		?	?	5.007	0.025
?	是	10(47.6)	4(16.7)	?	?
?	否	11(52.4)	20(83.3)	?	?

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