Kelleher Michaela M B
Nephrology, Prince of Wales Hospital, Randwick, New South Wales.
Br J Nurs. 2002;11(2):84-90. doi: 10.12968/bjon.2002.11.2.9308.
In the fields of both nursing and medicine there is a dearth of published literature on the optimum time to remove indwelling urinary catheters (IDCs) following urological surgery. Tradition seems to be in favour of removing IDCs at 0600 hours despite a lack of evidence to support this practice. This study was undertaken to determine whether midnight removal of IDCs resulted in patients' resuming normal voiding patterns. A prospective clinical trial was conducted to determine the impact midnight removal of urinary catheters would have on the patients' voiding pattern, and subsequent discharge from hospital. One hundred and sixty patients were entered into the study. The patients were allocated at random to have their urinary catheter removed either at midnight or at 0600 hours. Patients who had their catheters removed at midnight passed a greater volume of urine with both their first (268 ml compared with 177 ml; P<0.0001) and second voids (322 ml compared with 195 ml; P<0.0001) than their counterparts in the 0600 group. This permitted earlier discharge from hospital. The results reported in this study support the findings of earlier research that midnight removal of IDC leads to an earlier resumption of normal voiding patterns, permits earlier discharge from hospital and appears to reduce patients' anxiety. The recommendation from this study is that there should be a change in hospital policy so that the majority of IDCs are removed at midnight.
在护理和医学领域，关于泌尿外科手术后拔除留置导尿管（IDC）的最佳时间，发表的文献匮乏。尽管缺乏证据支持，但传统做法似乎倾向于在06:00拔除IDC。本研究旨在确定午夜拔除IDC是否能使患者恢复正常排尿模式。进行了一项前瞻性临床试验，以确定午夜拔除尿管对患者排尿模式及随后出院的影响。160名患者参与了该研究。患者被随机分配在午夜或06:00拔除尿管。午夜拔除尿管的患者首次排尿量（268毫升，而06:00组为177毫升；P<0.0001）和第二次排尿量（322毫升，而06:00组为195毫升；P<0.0001）均多于06:00组的患者。这使得患者能够更早出院。本研究报告的结果支持了早期研究的发现，即午夜拔除IDC可导致更早恢复正常排尿模式，允许更早出院，且似乎能减轻患者的焦虑。本研究的建议是，医院政策应有所改变，以便大多数IDC在午夜拔除。
