Effect of preoperative urination training combined with restrictive fluid therapy with enhanced recovery after surgery on postoperative urination in total knee arthroplasty patients_West China Medical Journal

Authors：

DUAN Shanshan ,  NING Ning , ZHOU Ting , LI Peifang , WANG Ke , LI Lingli , HOU Xiaoling

Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

NING Ning, Email: gkningning@126.com

Keywords：

Enhanced recovery after surgery; Total knee arthroplasty; Restrictive fluid therapy; Urination training

DOI：

10.7507/1002-0179.201809135

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To study the effect of preoperative urination training combined with restrictive fluid therapy with enhanced recovery after surgery (ERAS) on postoperative urination in total knee arthroplasty (TKA) patients. Methods A total of 150 patients who were conducted the unilateral TKA from March to May 2018 were divided into two groups, the trial group and the control group, with 75 patients in each group. The patients in the control group did not undergo urination training before surgery and were given liberal intravenous fluid therapy on the day of surgery; while the patients in the trial group received urination training before surgery and were given restrictive fluid therapy on the day of surgery. The pre-, intra-, and post-operative infusion volume and the total infusion volume on the day of surgery of the two groups were recorded; and the urination situation, urination time for the first time and the hospital days in the two groups were compared. Results The total infusion volume on the day of surgery in the trial group and the control group was (1 581.40±277.54) and (2 395.00±257.40) mL, respectively. After operation, in the trial group, there were 73 patients with smooth urinating, 2 with smooth urinating after inducing method, and none with urethral catheterization; in the control group, there were 66 patients with smooth urinating, 3 with smooth urinating after inducing method, and 6 with urethral catheterization. The urination time for the first time after operation in the trial group and the control group was (1.85±0.91) and (2.93±1.48) hours after back to the ward, respectively. These differences between the two groups were statistically significant (P<0.05). The hospital stay in the trial group and the control group was (5.86±2.48) and (6.28±1.60) days, respectively, and the difference between the two groups was not statistically significant (P>0.05). Conclusions Preoperative urination training combined with restrictive fluid therapy (the total infusion volume controls in about 1 500 mL on the day of surgery) in the TKA patients after ERAS is good for postoperation urination. It also can reduce the rate of postoperative urinary retention, and enhance rehabilitation.

Citation： DUAN Shanshan, NING Ning, ZHOU Ting, LI Peifang, WANG Ke, LI Lingli, HOU Xiaoling. Effect of preoperative urination training combined with restrictive fluid therapy with enhanced recovery after surgery on postoperative urination in total knee arthroplasty patients. West China Medical Journal, 2018, 33(12): 1491-1494. doi: 10.7507/1002-0179.201809135 Copy

1.	Stowers MD, Manuopangai L, Hill AG, et al. Enhanced recovery after surgery in elective hip and knee arthroplasty reduces length of hospital stay. ANZ J Surg, 2016, 86(6): 475-479.
2.	耿晴晴. 预防骨科术后尿潴留的国内研究近况. 实用医药杂志, 2013, 30(11): 1040-1043.
3.	Hollman F, Wolterbeek N, Veen R. Risk factors for postoperative urinary retention in men undergoing total hip arthroplasty. Orthopedics, 2015, 38(6): e507-e511.
4.	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 Arthroplasty, 2015, 30(3): 502-506.
5.	Mcdonald DA, Siegmeth R, Deakin AH, et al. An enhanced recovery programme for primary total knee arthroplasty in the United Kingdom - follow up at one year. Knee, 2012, 19(5): 525-529.
6.	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 Bone Joint Surg Am, 2013, 95(16): 1498-1503.
7.	陈有荣, 文鹏飞, 郭万首, 等. 初次髋膝关节置换术中不留置尿管的可行性和安全性研究. 中华关节外科杂志: 电子版, 2018, 12(3): 350-355.
8.	Boulis NM, Mian FS, Rodriguez D, et al. Urinary retention following routine neurosurgical spine procedures. Surg Neurol, 2001, 55(1): 23-27; discussion 27-28.
9.	郭文玉. 排尿训练对预防骨科术后患者尿潴留的效果观察. 当代护士: 专科版, 2012(1): 50-51.
10.	张少云, 曹国瑞, 裴福兴. 髋、膝关节置换术加速康复围术期液体治疗方案. 中国矫形外科杂志, 2018, 26(3): 234-237.
11.	雷一霆, 黄强, 张少云, 等. 人工全髋关节置换术围术期限制性输液联合术前排尿训练的临床研究. 中国修复重建外科杂志, 2017, 31(11): 1295-1299.
12.	梁兰. 骨科患者术后尿潴留的相关因素与护理进展. 世界最新医学信息文摘, 2015, 15(9): 34-36.
13.	王帮琼. 骨科手术病人术前排尿训练对手术后患者排尿影响的分析. 中外医疗, 2010, 29(4): 86.
14.	张少云, 黄强, 曹国瑞, 等. 加速康复外科模式下全膝关节置换术围术期限制性输液的临床研究. 中国矫形外科杂志, 2017, 25(17): 1567-1571.
15.	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. 中华骨与关节外科杂志, 2016, 9(1): 1-9.
16.	裴福兴, 翁习生. 现代关节置换术加速康复与围手术期管理. 北京: 人民卫生出版社, 2017.
17.	杨晓娟, 缪云仙, 杨树琴. 术前排尿训练对甲状腺肿瘤患者术后排尿的影响分析. 当代护士: 上旬刊, 2017(1): 74-75.
18.	孙美芝, 唐霖. 骨科术后尿潴留的相关因素研究现状. 中国误诊学杂志, 2011, 11(20): 4807-4808.
19.	汪涛, 陈莉. 术前排尿训练对心血管介入患者术后排尿的影响探究. 中国医药指南, 2017, 15(35): 171-172.

1. Stowers MD, Manuopangai L, Hill AG, et al. Enhanced recovery after surgery in elective hip and knee arthroplasty reduces length of hospital stay. ANZ J Surg, 2016, 86(6): 475-479.
2. 耿晴晴. 预防骨科术后尿潴留的国内研究近况. 实用医药杂志, 2013, 30(11): 1040-1043.
3. Hollman F, Wolterbeek N, Veen R. Risk factors for postoperative urinary retention in men undergoing total hip arthroplasty. Orthopedics, 2015, 38(6): e507-e511.
4. 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 Arthroplasty, 2015, 30(3): 502-506.
5. Mcdonald DA, Siegmeth R, Deakin AH, et al. An enhanced recovery programme for primary total knee arthroplasty in the United Kingdom - follow up at one year. Knee, 2012, 19(5): 525-529.
6. 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 Bone Joint Surg Am, 2013, 95(16): 1498-1503.
7. 陈有荣, 文鹏飞, 郭万首, 等. 初次髋膝关节置换术中不留置尿管的可行性和安全性研究. 中华关节外科杂志: 电子版, 2018, 12(3): 350-355.
8. Boulis NM, Mian FS, Rodriguez D, et al. Urinary retention following routine neurosurgical spine procedures. Surg Neurol, 2001, 55(1): 23-27; discussion 27-28.
9. 郭文玉. 排尿训练对预防骨科术后患者尿潴留的效果观察. 当代护士: 专科版, 2012(1): 50-51.
10. 张少云, 曹国瑞, 裴福兴. 髋、膝关节置换术加速康复围术期液体治疗方案. 中国矫形外科杂志, 2018, 26(3): 234-237.
11. 雷一霆, 黄强, 张少云, 等. 人工全髋关节置换术围术期限制性输液联合术前排尿训练的临床研究. 中国修复重建外科杂志, 2017, 31(11): 1295-1299.
12. 梁兰. 骨科患者术后尿潴留的相关因素与护理进展. 世界最新医学信息文摘, 2015, 15(9): 34-36.
13. 王帮琼. 骨科手术病人术前排尿训练对手术后患者排尿影响的分析. 中外医疗, 2010, 29(4): 86.
14. 张少云, 黄强, 曹国瑞, 等. 加速康复外科模式下全膝关节置换术围术期限制性输液的临床研究. 中国矫形外科杂志, 2017, 25(17): 1567-1571.
15. 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. 中华骨与关节外科杂志, 2016, 9(1): 1-9.
16. 裴福兴, 翁习生. 现代关节置换术加速康复与围手术期管理. 北京: 人民卫生出版社, 2017.
17. 杨晓娟, 缪云仙, 杨树琴. 术前排尿训练对甲状腺肿瘤患者术后排尿的影响分析. 当代护士: 上旬刊, 2017(1): 74-75.
18. 孙美芝, 唐霖. 骨科术后尿潴留的相关因素研究现状. 中国误诊学杂志, 2011, 11(20): 4807-4808.
19. 汪涛, 陈莉. 术前排尿训练对心血管介入患者术后排尿的影响探究. 中国医药指南, 2017, 15(35): 171-172.

West China Medical Journal

Effect of preoperative urination training combined with restrictive fluid therapy with enhanced recovery after surgery on postoperative urination in total knee arthroplasty patients

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content