Effect of optimized postoperative urinary catheterization after total knee arthroplasty based on fast track theory
YOU Tian1 WANG Shuang1 WEN Qinqin1 HU Huiying2 XIAO Yingui1 LI Jiuqun1
1.Department of Sport Medicine, Peking University Shenzhen Hospital, Guangdong Province, Shenzhen 518000, China;
2.Department of Ultrasonic Imaging Division, Peking University Shenzhen Hospital, Guangdong Province, Shenzhen 518000, China
Abstract：Objective To discuss the effect of optimized postoperative urinary catheterization after total knee arthroplasty (TKA) based on fast track theory. Methods From January to June 2015, in Peking University Shenzhen Hospital, 100 patients underwent TKA were selected, according to random number table, they were divided into control group (all indwelling catheter) and trial group (catheterization threshold of 500 mL), with 50 cases in each group. The time and volume of first voluntary micturition, urinary tract infection, urination comfort index were observed and compared. Results The first urination time of trial group were shorter than control group, the difference was statistically significant (P < 0.05). the difference was statistically significant (P < 0.05). The first urination volume of trial group were more than control group, the difference was statistically significant (P < 0.05). The comfort index of trial group were better than control group, the difference was statistically significant (P < 0.05). The urinary tract infection rate of two groups were compared, the difference was not statistically significant (P > 0.05). Conclusion In fast-track TKA, a bladder volume of 500 mL is reasonable and safe catheterization threshold, which can relieve the discomfort effectively, and speed the recovery postoperatively.
尤田1 王霜1 温琴琴1 胡会英2 肖银贵1 李九群1. 基于快速康复理论优化术后尿管应用在全膝关节置换术中的效果观察[J]. 中国医药导报, 2017, 14(16): 47-50.
YOU Tian1 WANG Shuang1 WEN Qinqin1 HU Huiying2 XIAO Yingui1 LI Jiuqun1. Effect of optimized postoperative urinary catheterization after total knee arthroplasty based on fast track theory. 中国医药导报, 2017, 14(16): 47-50.
[1] Balderi T，Carli F. Urinary retention after total hip and knee arthroplasty [J]. Minerva Anestesiologica，2010，76（2）：120-130.
[2] Huang Z，Ma J，Shen B，et al. General anesthesia： to catheterize or not? A prospective randomized controlled study of patients undergoing total knee arthroplasty [J]. J Arthroplasty，2015，30（3）：502-506.
[3] 周宗科，翁习生，曲铁兵，等.中国髋、膝关节置换术加速康复——围术期管理策略专家共识[J].中国骨与关节外科，2016，9（1）：10-15.
[4] Choi S，Mahon P，Awad IT. Neuraxial anesthesia and bladder dysfunction in the perioperative period： a systematic review [J]. Canadian Anaesth Soc J，2012，59（7）：681-703.
[5] Brouwer TA，Rosier PF，Moons KG，et al. Postoperative bladder catheterization based on individual bladder capacity：a randomized trial [J]. Anesthesiology，2015，122（1）：46-54.
[6] Madersbacher H，Cardozo L，Chapple C，et al. What are the causes and consequences of bladder overdistension ICI-RS 2011 [J]. Neurourol Urodynam，2012，31（3）：317-321.
[7] Bjerregaard LS，Hornum U，Troldborg C，et al. Postoperative urinary catheterization thresholds of 500 versus 800 ml after fast-track total hip and knee arthroplasty： a randomized，open-label，controlled trial [J]. Anesthesiology，2016， 124（6）：1256-1264.
[8] Choi S，Awad I. Maintaining micturition in the perioperative period： strategies to avoid urinary retention [J]. Current Opin Anaesthesiol，2013，26（3）：361-367.
[9] Kehlet H． Fast-track surgery-an update on physiological care principles to enhance recovery [J]. Langenbecks Arch Surg，2011，396（5）：585-590.
[10] 朱美玲.快速康复外科理念在普外科围术期健康教育中的应用[J].中国医药导报，2014，11（29）：112-115.
[11] 刘力婕，武永洁，薛志芳，等.快速康复教育路径在胰腺癌患者围术期中的应用[J].中国医药导报，2016，13（2）：145-149.
[12] 蘧勐，周群燕.快速康复理念对腹腔镜胃癌根治术后疼痛、炎性反应和胃肠功能的影响[J].中国医药导报，2016，13（17）：97-100.
[13] Zoremba M，Kratz T，Dette F，et al. Supplemental interscalene blockade to general anesthesia for shoulder arthro-scopy：effects on fast track capability，analgesic quality，and lung function [J]. Biomed Res Int，2015，2015：325012.
[14] Ali Hassan HI. Comparison between two different selective spinal anesthesia techniques in ambulatory knee arthroscopy as fast-track anesthesia [J]. Anesth Essays Res，2015，9（1）：21-27.
[15] Lloyd JM，Wainwright T，Middleton RG. What is the role of minimally invasive surgery in a fast track hip and knee replacement pathway? [J]. Ann R Coll Surg Engl，2012，94（3）：148-151.
[16] Bjerregaard LS，Bagi P，Kehlet H. Postoperative urinary retention （POUR） in fast-track total hip and knee arthroplasty [J]. Acta Orthopaedica，2014，85（1）：8-10.
[17] Wein AJ，Roehrborn CG，Kaplan SA，et al. Urinary retention and post-void residual urine in men：separating truth from tradition [J]. J Urol，2008，180（1）：47-54.
[18] Wu AK，Auerbach AD，Aaronson DS. National incidence and outcomes of postoperative urinary retention in the Surgical Care Improvement Project [J]. Am J Surg，2012， 204（2）：167-171.
[19] Panteli M，Habeeb S，Mcroberts J，et al. Enhanced care for primary hip arthroplasty： factors affecting length of hospital stay [J]. Eur J Orthop Surg Traumatol，2014，24（3）：353-358.
[20] Kehlet H. Fast-track hip and knee arthroplasty [J]. Lancet，2013，381（9878）：1600-1602.
[21] Kieffer WK，Kane TP. Predicting postoperative urinary retention after lower limb arthroplasty [J]. Ann Royal Coll Surg Engl，2012，94（5）：356-358.
[22] Griesdale DE，Neufeld J，Dhillon D，et al. Risk factors for urinary retention after hip or knee replacement： a cohort study [J]. Canadian Anaesth Soc J，2011，58（12）：1097-1104.
[23] Miller AG，Mckenzie J，Greenky M，et al. Spinal anesthesia： should everyone receive a urinary catheter? a randomized，prospective study of patients undergoing total hip arthroplasty [J]. J Bone Joint Surg，2013，95（16）：1498-1503.
[24] Zhang W，Liu A，Hu D，et al. Indwelling versus intermittent urinary catheterization following total joint arthroplasty：a systematic review and meta-analysis [J]. PLoS One，2015，10（7）：e0130636.
[25] Nyman MH，Gustafsson M，Langius-Ekl■f A，et al. Intermittent versus indwelling urinary catheterisation in hip surgery patients：a randomised controlled trial with cost-effectiveness analysis [J]. Int J Nurs Stud，2013，50（12）：1589-1598.
[26] Michelson JD，Lotke PA，Steinberg ME. Urinary-bladder management after total joint-replacement surgery [J]. New Engl J Med，1988，319（6）：321-326.
[27] Harsten A，Kehlet H，Ljung P，et al. Total intravenous general anaesthesia vs. spinal anaesthesia for total hip arthroplasty：a randomised，controlled trial [J]. Acta Anaesthesiologica Scandinavica，2015，59（3）：298-309.
[28] Harsten A，Kehlet H，Toksviglarsen S. Recovery after total intravenous general anaesthesia or spinal anaesthesia for total knee arthroplasty：a randomized trial [J]. British J Anaesthesia，2013，111（3）：391-399.
[29] 薛官国.基于快速康复理念下腹腔镜胆囊切除手术患者的麻醉管理[J].中国现代医生，2015，53（10）：117-119.
2017, Vol. 14 
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