术前膀扫描可以预测术后尿在全关节形术后
Robert James Magaldi1,2, Sara Elaine Strecker2, Carl W Nissen2
1Division of Orthopaedic Surgery, Jefferson Health, Stratford, New Jersey.
The Journal of bone and joint surgery. American volume
|February 20, 2024
概括
手术后的尿 (POUR) 可以在全关节整形术 (TJA) 后延迟当天排泄. 术前膀扫描,特别是空虚后残留体积 (PVRV),有效地预测POUR风险,与AUA症状调查不同.
科学领域:
- 整形外科手术 整形外科手术
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 患者的治疗结果.
背景情况:
- 手术后尿 (POUR) 是在全关节整形术 (TJA) 中同日排泄的一个重大问题.
- 目前存在的POUR风险因素缺乏明确的临床实用性,需要对手术前预测因素进行手术规划的调查.
- 这项研究旨在评估手术前的症状调查和膀扫描,以确定患有POUR风险的患者.
研究的目的:
- 确定美国泌尿病学会 (AUA) 手术前症状指数和膀扫描在预测全关节整形术 (TJA) 患者手术后尿 (POUR) 的有用性.
- 确定特定的手术前因素,可以帮助手术规划和患者优化TJA.
- 评估术前术后空气残留体积 (PVRV) 与POUR发生率之间的相关性.
主要方法:
- 对507名接受全关节整形术 (THA) 和全膝关节整形术 (TKA) 的患者进行前性分析.
- 美国泌尿器官学会 (AUA) 的术前和术后管理症状指数.
- 手术前后空气膀扫描以测量空气后残留体积 (PVRV).
- POUR定义为膀体积>500毫升,需要导管;统计分析包括千平方,五分位数分析和Student t测试.
主要成果:
- 在TKA患者中,POUR的发生率为37%,在THA患者中为23%.
- 术前PVRV的增加是POUR的重要预测因素.
- 在TKA或THA队列中,AUA症状调查与POUR没有相关性.
结论:
- 术前膀超声波,特别是PVRV测量,是预测TJA患者的POUR的一个有价值的工具.
- 预见到,随着PVRV从50升至200毫升,导管率的指数式增加被观察到.
- 建议对TJA患者进行常规的手术前膀扫描,特别是那些在同一天出院的患者,以减轻POUR风险.
相关概念视频
Urinary Tract Calculi VI: Surgical Management
Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
Imaging Studies I: Kidney, Ureter, and Bladder Studies
Kidney, Ureter, and Bladder (KUB) StudiesKidney, Ureter, and Bladder (KUB) studies are standard diagnostic imaging procedures used to assess the anatomy of the urinary system. They are commonly utilized for patients experiencing abdominal pain or urinary symptoms. By using a simple X-ray of the abdomen, KUB studies can reveal structural and pathological abnormalities within the kidneys, ureters, and bladder. These studies are particularly valuable in diagnosing kidney stones, urinary...
Imaging Studies II: Ultrasonography
IntroductionUltrasonography, or renal ultrasound, is a noninvasive medical imaging technique that uses high-frequency sound waves to visualize the kidneys, ureters, bladder, and surrounding tissues.Indications for Urinary System UltrasonographyUrinary system ultrasonography is indicated in various clinical scenarios, such as:Kidney Stones (Urolithiasis): To detect and monitor the size and presence of kidney or urinary tract stones.Hydronephrosis: To assess the dilation of the renal pelvis and...
Imaging Studies III: Computed Tomography
DefinitionComputed Tomography (CT) of the genitourinary (GU) tract is a non-invasive imaging modality that utilizes X-rays and computer processing to generate detailed cross-sectional images of the urinary system, encompassing the kidneys, ureters, bladder, and adjacent structures such as the adrenal glands.PurposeCT scans of the GU tract serve several diagnostic and therapeutic purposes, including:Diagnosis of Urinary Tract Diseases: Detects kidney stones, tumors, cysts, and congenital...
Imaging Studies V: Intravenous Urography and Retrograde Pyelography
IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
Imaging Studies VI: Voiding Cystourethrography and Cystography
Voiding Cystourethrography (VCUG) and Cystography are specialized radiographic procedures used to examine the structure and function of the bladder and urethra.Voiding Cystourethrography (VCUG)A Voiding Cystourethrogram (VCUG) is a diagnostic imaging procedure that assesses the anatomy and function of the lower urinary tract. It focuses on the bladder, bladder neck, and urethra, helping detect abnormalities such as vesicoureteral reflux (VUR)—the backward or reverse flow of urine into the...


