生姜外敷穴位联合新斯的明预防腰麻术后尿潴留的研究

魏桂花 黄健 郑圆媛

【摘要】 目的：探讨生姜外敷穴位联合新斯的明预防腰麻术后尿潴留的临床效果。方法：将2020年1月-2021年9月本院收治的80例腰麻术后患者随机分为观察组（生姜外敷穴位联合新斯的明）和对照组（热敷、听流水声、定时排尿）。比较两组术后首次排尿时间、膀胱残余尿量、导尿率、腰麻后平面消退達胸10时输液量、术后首次排尿量，记录两组下腹坠胀、排尿不尽感等不适反应发生率。结果：观察组术后首次排尿时间早于对照组，膀胱残余尿量少于对照组，首次排尿量多于对照组，差异均有统计学意义（P<0.05）。两组腰麻后平面消退达胸10时输液量比较，差异无统计学意义（P>0.05）。观察组导尿率为5.00%，低于对照组的30.00%（P<0.05）。观察组下腹坠胀发生率、排尿不尽感发生率分别为5.00%、10.00%，均低于对照组的22.50%、35.00%，差异均有统计学意义（P<0.05）。结论：生姜外敷穴位联合新斯的明可缩短腰麻术后首次排尿时间，减轻术后不适感，能有效预防尿潴留，减少术后导尿率。

【关键词】 生姜 外敷穴位 腰麻 尿潴留

Study on Ginger External Application Combined with Neostigmine on Preventing Urinary Retention after Lumbar Anesthesia/WEI Guihua， HUANG Jian， ZHENG Yuanyuan. //Medical Innovation of China， 2021， 18（35）： 0-089

[Abstract] Objective： To explore the curative effect of ginger external application combined with Neostigmine on preventing urinary retention after lumbar anesthesia. Method： A total of 80 patients undergoing lumbar anesthesia in our hospital from January 2020 to September 2021 were randomly divided into the observation group （ginger external application combined with Neostigmine） and the control group （hot compress， listening to running water， regular urination）. The first urination time after treatment， residual urine volume of bladder， catheterization rate， amount of fluid infusion after lumbar anesthesia when plane subsided to the chest 10， and the first urination volume after treatment of two groups were compared， the incidence of discomforts such as lower abdomen distension and incomplete urination in two groups were recorded. Result： The first urination time after treatment of the observation group was earlier than that of the control group， the residual urine volume of bladder was less than that of the control group， and the the first urination volume after treatment was more than that of the control group， the differences were statistically significant （P<0.05）. There was no significant difference in the amount of fluid infusion after lumbar anesthesia when plane subsided to the chest 10 between two groups （P>0.05）. The catheterization rate of the observation group was 5.00%， which was lower than 30.00% of the control group （P<0.05）. The first postoperative urine output in the observation group was greater than that in the control group， and the difference was statistically significant （P<0.05）. The incidences of lower abdomen distension and incomplete urination in the observation group were 5.00% and 10.00% respectively， which were lower than 22.50% and 35.00% in the control group， the differences were statistically significant （P<0.05）. Conclusion： Ginger external application combined with Neostigmine can shorten the first urination time after lumbar anesthesia， reduce postoperative discomfort， effectively prevent urinary retention， and reduce postoperative catheterization rate.

[Key words] Ginger External application on acupoints Lumbar anesthesia Urinary retention

First-author’s address： Jiujiang First People’s Hospital， Jiujiang 332000， China

doi：10.3969/j.issn.1674-4985.2021.35.021

蛛网膜下腔阻滞麻醉（简称腰麻）是普外科手术中常用的麻醉方式，常用于腹股沟疝、痔疮、肛瘘、下肢大隐静脉曲张等手术，术中一般不需留置尿管，但患者术后常发生尿潴留。术后尿潴留，不但增加患者的痛苦，增加医疗费用，而且对患者疾病的恢复也极为不利。为了防止腰麻术后出现尿潴留，以往常给予热敷、听流水声等方法，但疗效欠佳。此类患者实施针灸、艾灸等中医治疗，虽有一些疗效，但仍有部分患者对这种治疗不敏感或担心被伤着，拒绝治疗。……