Feasibility and safety of non-indwelling urinary catheter in patients received primary hip or knee arthroplasty

doi:10.3877/cma.j.issn.1674-134X.2018.03.009

Abstract

Abstract:

Objective

To evaluate the feasibility and safety of non-indwelling urinary catheter in the patients who receive unilateral primary hip or knee arthroplasty.

Methods

A retrospective study was carried out to analyze 109 patients who received unilateral primary hip or knee arthroplasty during Nov 2015 to Oct 2016 in China-Japan Friendship Hospital with non-indwelling catheter (NIC) and without obvious risk factors for urinary retention, preoperative urinary tract infection, urinary tract irritation or severe hepatorenal insufficiency. According to 1 ∶1 matching pair principle, they were paired with patients who received unilateral primary hip or knee arthroplasty with indwelling catheter (IC) during the same period. The feasibility and safety of non-indwelling urinary catheter was analyzed and evaluated by comparing the incidence of postoperative urinary retention, urinary retention recurrence, catheter-related bladder discomfort, urinary irritation symptoms, urinary tract infection, adverse events, postoperative hospitalization time and patient satisfaction between the NIC and IC groups. The SPSS19.0 statistics software was used to test the measurement data of normal distribution by paired t test, the measurement data of non-normal distribution by Wilcoxon signed rank sum test and the enumeration data by χ² test.

Results

There was no significant difference (P>0.05) in terms of postoperative urinary retention, urinary retention recurrence or urinary tract infection between the two groups. The incidence of catheter-related bladder discomfort, urinary irritation symptoms, adverse events and postoperative hospitalization time in NIC group was significantly less and patient satisfaction was significantly higher than IC group (χ²=10.844, P<0.05). The rate of unnecessary catheterization in the patients who receive unilateral primary hip or knee arthroplasty was 81.7%.

Conclusion

Non-indwelling urinary catheter in patients who received primary hip or knee arthroplasty is safe and reliable, which could reduce the incidence of catheter-related bladder discomfort, urinary irritation symptoms and adverse events effectively, and shorten the postoperative hospitalization time, improve early patient satisfaction.

Key words: Urinary catheters, Hip, Knee, Arthroplasty, Urinary retention

Yourong Chen, Pengfei Wen, Wanshou Guo, Weiguo Wang, Zhaohui Liu, Qidong Zhang, Ran Ding. Feasibility and safety of non-indwelling urinary catheter in patients received primary hip or knee arthroplasty[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2018, 12(03): 350-355.

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References 23

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组别	例数	年龄[岁，(±s)]	BMI[kg/m^2, (±s)]	ASA分级(例)			残余尿量[ml, (±s)]	禁水时间[h, (±s)]	术前补液量[ml, M(P25，P75)]
组别	例数	年龄[岁，(±s)]	BMI[kg/m^2, (±s)]	Ⅰ级	Ⅱ级	Ⅲ级	残余尿量[ml, (±s)]	禁水时间[h, (±s)]	术前补液量[ml, M(P25，P75)]
NIC组	109	61.9±10.6	25.8±3.7	4	91	14	31.8±24.2	7.0±1.7	0(0, 500)
IC组	109	62.2±10.6	25.8±3.8	6	87	16	29.0±22.2	7.0±1.7	0(0, 500)
统计值	?	t＝－1.122	t＝－0.235	χ²＝0.623			t＝0.845	t＝0.390	Z＝－0.308
P值	?	>0.05	>0.05	>0.05			>0.05	>0.05	>0.05

组别	例数	年龄[岁，(±s)]	BMI[kg/m^2, (±s)]	ASA分级(例)			残余尿量[ml, (±s)]	禁水时间[h, (±s)]	术前补液量[ml, M(P25，P75)]
组别	例数	年龄[岁，(±s)]	BMI[kg/m^2, (±s)]	Ⅰ级	Ⅱ级	Ⅲ级	残余尿量[ml, (±s)]	禁水时间[h, (±s)]	术前补液量[ml, M(P25，P75)]
NIC组	109	61.9±10.6	25.8±3.7	4	91	14	31.8±24.2	7.0±1.7	0(0, 500)
IC组	109	62.2±10.6	25.8±3.8	6	87	16	29.0±22.2	7.0±1.7	0(0, 500)
统计值	?	t＝－1.122	t＝－0.235	χ²＝0.623			t＝0.845	t＝0.390	Z＝－0.308
P值	?	>0.05	>0.05	>0.05			>0.05	>0.05	>0.05

组别	例数	补液总量[ml, (±s)]	术中失血量[ml, M(P25，P75)]	术中输血量[ml, M(P25，P75)]	手术时间[min, (±s)]	术后即刻膀胱容积/尿量[ml, (±s)]	术后VAS评分(±s)	术后住院时间[d，(±s)]
NIC组	109	1640.7±323.0	200.0(120，350)	0(0，180)	95.1±26.1	226.1±100.6	2.6±1.1	6.3±2.5
IC组	109	1673.8±346.1	210.0(100，300)	0(0，150)	94.5±26.4	238.3±136.0	2.8±1.5	7.5±3.1
统计值	?	t＝－1.076	Z ＝－0.799	Z ＝－0.790	t＝0.202	t＝0.940	t＝－0.946	t＝－3.132
P值	?	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	<0.01

组别	例数	补液总量[ml, (±s)]	术中失血量[ml, M(P25，P75)]	术中输血量[ml, M(P25，P75)]	手术时间[min, (±s)]	术后即刻膀胱容积/尿量[ml, (±s)]	术后VAS评分(±s)	术后住院时间[d，(±s)]
NIC组	109	1640.7±323.0	200.0(120，350)	0(0，180)	95.1±26.1	226.1±100.6	2.6±1.1	6.3±2.5
IC组	109	1673.8±346.1	210.0(100，300)	0(0，150)	94.5±26.4	238.3±136.0	2.8±1.5	7.5±3.1
统计值	?	t＝－1.076	Z ＝－0.799	Z ＝－0.790	t＝0.202	t＝0.940	t＝－0.946	t＝－3.132
P值	?	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	<0.01

组别	例数	尿管相关膀胱不适(例)		尿路刺激征(例)	尿路感染(例)	不良事件(例)	术后尿潴留(例)	患者满意度(例)
组别	例数	中度不适	重度不适	尿路刺激征(例)	尿路感染(例)	不良事件(例)	术后尿潴留(例)	满意	非常满意
NIC组	109	12	0	5	0	3	20	57	41
IC组	109	55	3	22	2	10	13	49	30
统计值	?	χ²＝44.53		χ²＝12.217	－	χ²＝4.008	χ²＝1.750	χ²＝10.844
P值	?	<0.01		<0.01	0.498^a	<0.05	>0.05	<0.01

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