Liang Ching-Chung, Lee Chyi-Long, Chang Ting-Chang, Chang Yao-Lung, Wang Chin-Jung, Soong Yung-Kuei
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Kweishan, Taoyuan, Taiwan.
Int Urogynecol J Pelvic Floor Dysfunct. 2009 Mar;20(3):295-300. doi: 10.1007/s00192-008-0769-6. Epub 2008 Nov 14.
The objective of this study is to assess the impact of bladder catheterization on the incidence of postoperative urinary tract infection (UTI) and urinary retention (PUR) following laparoscopic-assisted vaginal hysterectomy (LAVH). One hundred fifty patients undergoing LAVH were randomly assigned to no catheter use, 1-day, and 2-day catheter groups. The relationship between preoperative, intraoperative, and postoperative factors and the rates of UTI and PUR were determined. The incidences of UTI and PUR were 9.3% and 18.7%, respectively. The highest rate of UTI occurred in the 2-day catheter group; the highest rate of PUR occurred in no-catheter-use group. Multivariable logistical regression showed the duration of catheterization was the single predictor of UTI; duration of catheterization and diabetes mellitus were predictors for PUR. While short-term indwelling catheterization resulted in decreased rate of PUR, UTI rate increased among patients undergoing LAVH. Nonetheless, most patients resumed normal urination shortly after surgery.
本研究的目的是评估膀胱插管对腹腔镜辅助阴式子宫切除术后尿路感染(UTI)和尿潴留(PUR)发生率的影响。150例行腹腔镜辅助阴式子宫切除术的患者被随机分为不使用导管组、使用1天导管组和使用2天导管组。确定术前、术中和术后因素与UTI和PUR发生率之间的关系。UTI和PUR的发生率分别为9.3%和18.7%。UTI发生率最高的是使用2天导管组;PUR发生率最高的是不使用导管组。多变量逻辑回归显示,导尿持续时间是UTI的唯一预测因素;导尿持续时间和糖尿病是PUR的预测因素。虽然短期留置导尿可降低PUR发生率,但腹腔镜辅助阴式子宫切除术患者的UTI发生率会增加。尽管如此,大多数患者术后不久即恢复正常排尿。