丙泊酚联合七氟烷麻醉对胸腔手术患者术后导尿管相关膀胱刺激征的影响

翁海杰 郭植君

【摘要】 目的：分析丙泊酚聯合七氟烷麻醉对胸腔手术患者术后导尿管相关膀胱刺激征的影响。方法：选取2017年1月-2020年1月本院收治的80例胸腔手术患者，按照随机数字表法将其分为对照组和研究组，每组40例。对照组给予七氟烷麻醉治疗，研究组给予丙泊酚联合七氟烷麻醉治疗。比较两组麻醉恢复时间、术后4 h CRBD发生情况、QoR-40评分及并发症发生情况。结果：研究组自主呼吸恢复时间、气管导管拔管时间、苏醒时间均短于对照组，差异均有统计学意义（P<0.05）。研究组术后4 h CRBD发生率低于对照组，差异有统计学意义（P<0.05）。术前1 d，两组各维度QoR-40评分比较，差异均无统计学意义（P>0.05）;术后1 d，研究组各维度QoR-40评分高于对照组，差异均有统计学意义（P<0.05）。研究组不良反应发生率低于对照组，差异有统计学意义（P<0.05）。结论：丙泊酚联合七氟烷麻醉用于胸腔手术患者可缩短改善患者麻醉恢复时间，降低导尿管相关膀胱刺激征发生率，降低不良反应发生率，值得推广和应用。

【关键词】 丙泊酚 七氟烷 胸腔手术 导尿管相关膀胱刺激征

Effect of Propofol Combined with Sevoflurane Anesthesia on Catheter-related Bladder Discomfort after Thoracic Surgery/WENG Haijie， GUO Zhijun. //Medical Innovation of China， 2021， 18（31）： 0-057

[Abstract] Objective： To analyze the effect of Propofol combined with Sevoflurane anesthesia on catheter-related bladder discomfort after thoracic surgery. Method： A total of 80 thoracic surgery patients admitted to our hospital from January 2017 to January 2020 were selected， they were divided into control group and study group according to random number table method， 40 cases in each group. The control group was treated with Sevoflurane anesthesia， and the study group was treated with Propofol combined with Sevoflurane anesthesia. The recovery time of anesthesia， occurrence of 4 h CRBD after surgery， QoR-40 scores and incidence of complications were compared between two groups. Result： The recovery time of spontaneous breathing， extubation time of tracheal tube and awakening time in the study group were shorter than those in the control group， the differences were statistically significant （P<0.05）. The incidence of 4 h CRBD after surgery in the study group was lower than that in the control group， the difference was statistically significant （P<0.05）. 1 d before surgery， there were no significant differences in the scores of QoR-40 in all dimensions between two groups （P>0.05）; 1 d after surgery， the scores of QoR-40 in all dimensions in the study group were higher than those in the control group， the differences were statistically significant （P<0.05）. The incidence of adverse reaction in the study group was lower than that in the control group， the difference was statistically significant （P<0.05）. Conclusion： Propofol combined with Sevoflurane anesthesia for thoracic surgery patients can shorten and improve the recovery time of anesthesia， reduce the incidence of catheter-related bladder discomfort and reduce the incidence of adverse reactions， which is worthy of promotion and application.

[Key words] Propofol Sevoflurane Thoracic surgery Catheter-related bladder discomfort

First-author’s address： Dafeng Hospital of Shantou， Shantou 515100， China

doi：10.3969/j.issn.1674-4985.2021.31.013

胸腔手术是临床比较常见的手术类型，具有创伤性大、术后恢复时间长、并发症多等特点，手术过程需要为患者进行全身麻醉来配合完成手术。而留置导尿管是全麻手术一个必要的常规操作，留置导尿管时患者会有疼痛、紧张、恐惧等心理障碍。因此，一般在全麻后为患者留置导尿管。很多患者在术后会产生导尿管相关膀胱刺激征（CRBD），即患者在术后清醒时会出现不同程度的下腹部疼痛、尿频、尿急，烧灼感，严重的患者还会出现言语混乱、烦躁不安、肢体摆动等行为，引起患者心率加快、血压升高，甚至想要拔掉导尿管，给患者带来痛苦，影响患者的康复[1-2]。……