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接受腹腔镜胆囊切除术的女性术后尿潴留的危险因素。

Risk factors for postoperative urinary retention among women who underwent laparoscopic cholecystectomy.

作者信息

Choi Jae Hwi, Yoon Sol, Lee Sin Woo, Jeh Seong Uk, Hwa Jeong Seok, Hyun Jae Seog, Chung Ky Hyun, Seo Deok Ha, Lee Chunwoo, Kam Sung Chul, Choi See Min

机构信息

Department of Urology, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea.

Department of Urology, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea.

出版信息

Low Urin Tract Symptoms. 2019 May;11(3):158-162. doi: 10.1111/luts.12255. Epub 2019 Feb 3.

Abstract

OBJECTIVES

The aim of this study was to investigate the risk factors for postoperative urinary retention (POUR) among female patients by evaluating its occurrence in women who underwent laparoscopic cholecystectomy in Gyeongsang National University Hospital.

METHODS

The medical records of female patients who had undergone laparoscopic cholecystectomy for gallbladder stones between March 2014 and February 2018 were reviewed. Information was collected regarding patient age, body mass index (BMI), creatinine, absolute neutrophil count, duration of the operation and anesthesia, the amount of fluid infused, American Society of Anesthesiologists (ASA) classification, and medical comorbidities, such as hypertension, diabetes, and lung, liver, heart, renal, and neurologic disease. Comparisons were made between the POUR and non-POUR groups, and both univariate and multivariate analyses were conducted.

RESULTS

Seventeen of 591 patients (2.9%) developed POUR. There as a positive correlation between age and POUR (P = 0.040), and a negative correlation between BMI and POUR (P = 0.037). In addition, a history of neurologic disease was greater in the POUR group (P = 0.033), which also had a higher ASA class than the non-POUR group (P < 0.001). Multivariate analysis showed that a high ASA class was a risk factor for POUR (hazard ratio 3.01; 95% confidence interval 1.13-7.99; P = 0.027).

CONCLUSIONS

Medical care providers need to be aware of the risk factors for POUR, which is likely to prolong hospital stay for Foley catheter placement. A high ASA class is an important risk factor for POUR among female patients, so medical staff need to provide proper preoperative management strategies for patients with a high ASA class.

摘要

目的

本研究旨在通过评估庆尚国立大学医院接受腹腔镜胆囊切除术的女性患者术后尿潴留(POUR)的发生情况,调查女性患者术后尿潴留的危险因素。

方法

回顾了2014年3月至2018年2月间因胆囊结石接受腹腔镜胆囊切除术的女性患者的病历。收集了患者年龄、体重指数(BMI)、肌酐、绝对中性粒细胞计数、手术和麻醉持续时间、输液量、美国麻醉医师协会(ASA)分级以及高血压、糖尿病、肺、肝、心、肾和神经疾病等合并症的信息。对POUR组和非POUR组进行了比较,并进行了单因素和多因素分析。

结果

591例患者中有17例(2.9%)发生POUR。年龄与POUR呈正相关(P = 0.040),BMI与POUR呈负相关(P = 0.037)。此外,POUR组神经疾病史更多(P = 0.033),其ASA分级也高于非POUR组(P < 0.001)。多因素分析显示,高ASA分级是POUR的危险因素(风险比3.01;95%置信区间1.13 - 7.99;P = 0.027)。

结论

医疗服务提供者需要了解POUR的危险因素,这可能会延长因放置Foley导管而住院的时间。高ASA分级是女性患者POUR的重要危险因素,因此医务人员需要为高ASA分级的患者提供适当的术前管理策略。

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