Witt Michael, Baumann Brigitte M, McCans Kathryn
Department of Emergency Medicine, One Cooper Plaza, Camden, NJ 08103, USA.
Acad Emerg Med. 2005 Apr;12(4):371-4. doi: 10.1197/j.aem.2004.11.023.
To determine whether volumetric bladder ultrasound (VBUS) determinations improve the rate of successful pediatric catheterizations and caregiver satisfaction.
This randomized controlled trial was conducted at an urban academic emergency department. Patients younger than 36 months requiring diagnostic urine samples were randomized into one of two groups: VBUS or conventional catheterization (CC). Patients were excluded if they were critically ill or had genitourinary abnormalities. VBUS catheterizations were postponed for 30 minutes if the transverse bladder diameter was <2 cm. Data included demographics, number of catheterizations required for success (>/=2.5 mL urine) (SucC), and the number of postponed catheterizations. Caregiver satisfaction scores using a ten-point Likert scale (1 = poor, 10 = excellent) were obtained for time to SucC, physical handling of child (PhysH), and overall satisfaction. Descriptive statistics, chi-square tests, t-tests, and correlation coefficients were used where appropriate.
Of 64 patients, 33 underwent VBUS-guided catheterization. The groups did not differ regarding gender (39% male) and age (mean age: CC, 9.4 months, SD = 7.8; VBUS, 7.7 months, SD = 5.5; p = 0.33). SucC occurred in 94% (VBUS) versus 68% (CC) of patients (p = 0.007). The two groups did not differ on any of the caregiver satisfaction indices (time to SucC: VBUS = 8.9 vs. CC = 8.1; PhysH: VBUS = 9.3 vs. CC = 8.6; overall satisfaction: VBUS = 9.3 vs. CC = 8.5; all p > 0.15).
Although there was no significant difference in caregiver satisfaction between the VBUS and CC groups, implementation of VBUS greatly improved the success rates of pediatric emergency department catheterizations. This improvement is achieved with a rapid and easily mastered VBUS technique.
确定膀胱容积超声（VBUS）测定是否能提高小儿导尿成功率及护理人员满意度。
本随机对照试验在一家城市学术急诊科进行。需要采集诊断用尿液样本的36个月以下患儿被随机分为两组之一：VBUS组或传统导尿（CC）组。病情严重或有泌尿生殖系统异常的患者被排除。如果膀胱横径<2 cm，VBUS导尿推迟30分钟。数据包括人口统计学信息、成功导尿（尿液≥2.5 mL）所需的导尿次数（SucC）以及推迟导尿的次数。使用十点李克特量表（1 = 差，10 = 优）获得护理人员对达到SucC的时间、对患儿的身体操作（PhysH）和总体满意度的评分。在适当情况下使用描述性统计、卡方检验、t检验和相关系数。
64例患者中，33例接受了VBUS引导下的导尿。两组在性别（男性39%）和年龄方面无差异（平均年龄：CC组9.4个月，标准差=7.8；VBUS组7.7个月，标准差=5.5；p = 0.33）。患者中SucC发生率为94%（VBUS组）对68%（CC组）（p = 0.007）。两组在任何护理人员满意度指标上均无差异（达到SucC的时间：VBUS组=8.9，CC组=8.1；PhysH：VBUS组=9.3，CC组=8.6；总体满意度：VBUS组=9.3，CC组=8.5；所有p>0.15）。
虽然VBUS组和CC组在护理人员满意度方面无显著差异，但VBUS的实施大大提高了小儿急诊科导尿的成功率。这种提高是通过快速且易于掌握的VBUS技术实现的。
