Predictors of catheter-related bladder discomfort after urological surgery
Predictors of catheter-related bladder discomfort after urological surgery
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DOI：
10.1007/s11596-014-1315-z
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发表时间：
2014-08-01
影响因子：
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通讯作者：
Yang, Fan
中科院分区：
文献类型：
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作者：
Li, Cong;Liu, Zheng;Yang, Fan
本研究的目的是找出泌尿外科手术后早期导管相关性膀胱不适（CRBD）的预测因素。我们在我院设计了一项前瞻性观察研究。在3个月的时间内，在全身麻醉或硬膜外麻醉下接受手术需要导尿的连续性成人患者被纳入。膀胱不适的严重程度以4分量表评估：（1）无疼痛，（2）轻度疼痛（仅通过与患者面谈发现），（3）中度（患者自发主诉尿道灼热感和/或排尿冲动和/或尿道异物感，无任何情绪激动）和（4）严重不适（激动、大声抱怨和试图移除与尿道中的烧灼感相关的膀胱导管）。通过单因素和多因素分析确定CRBD的预测因素。共纳入116例患者，其中84.5%在第1天发生CRBD（轻度CRBD：40.5%;中度或重度CRBD：44.0%），31.9%在第3天发生CRBD（轻度CRBD：29.3%;中度或重度CRBD：2.6%）。对CRBD的9个潜在预测因素进行单因素卡方检验，男性OR=2.4，95%CI（1.1-5.6），P < 0.05]，开腹手术与经尿道手术比较[OR=0.3，95%CI（0.1-0.6），P < 0.05]，腹部手术与腹腔镜手术比较[OR=3.3，95%CI（1.2-8.9），P < 0.05]和导尿史[OR=0.5，95%CI（0.2-0.9），P < 0.05]是术后患者中重度CRBD的独立预测因素。多因素Logistic回归分析显示，开腹手术史[EXP（B）=3.074，95%CI（1.3-7.4），P < 0.05]和导尿史[EXP（B）=2.458，95%CI（1.1-5.9），P < 0.05]可能是中重度CRBD发生的重要因素。总之，这项观察性研究确定了手术类型和导管插入史可能是泌尿外科手术后中重度CRBD的预测因素。
The aim of this study was to figure out the predictors of early postoperative catheter-related bladder discomfort (CRBD) after urological surgery. We designed a prospective observational study in our hospital. Consecutive adult patients undergoing surgery under general anaesthesia or epidural anaesthesia necessitating urinary catheterization were included during a 3-month period. severity of bladder discomfort was assessed on a 4-point scale: (1) no pain, (2) mild pain (revealed only by interviewing the patient), (3) moderate (a spontaneous complaint by the patient of a burning sensation in the urethra and/or an urge to urinate and/or sensation of urethral foreign body without any emotional agitation) and (4) severe discomfort (agitation, loud complaints and attempt to remove the bladder catheter associated with a burning sensation in the urethra). Predictors of CRBD were identified by univariate and multivariate analysis. Totally, 116 patients were included, of which 84.5% had CRBD (mild CRBD: 40.5%; moderate or severe CRBD: 44.0%) at day 1, while 31.9% developed CRBD (mild CRBD: 29.3%; moderate or severe CRBD: 2.6%) at day 3. We evaluated 9 potential forecast factors of CRBD, and univariate Chi-square test showed male gender [OR=2.4, 95%CI (1.1-5.6), P < 0.05], abdominal open surgery compared with transurethral surgery [OR=0.3, 95%CI (0.1-0.6), P < 0.05], abdominal surgery compared with laparoscopic surgery [OR=3.3, 95%CI (1.2-8.9), P < 0.05] and history of catheterization [OR=0.5, 95%CI (0.2-0.9), P < 0.05] were independent predictors of moderate or severe CRBD in the patients after surgery. While multivariate logistic regression analysis showed that the abdominal open surgery [EXP(B)=3.074, 95%CI (1.3-7.4), P < 0.05] and the history of catheterization [EXP(B)=2.458, 95%CI (1.1-5.9), P < 0.05] might contribute more to the occurrence of moderate or severe CRBD. In conclusion, this observational study identified that the type of surgery and the history of catheterization might be predictive factors of moderate and severe CRBD after urological surgery.