在整形外科手术中保持尿液:基于证据的算法.
Aaron A Olsen1, Evan Crawford, Chad Pusateri
1From the Bone and Joint Sports Medicine Institute (Olsen, Crawford, and Shirley); Department of Urology, Naval Medical Center Portsmouth, Portsmouth, VA (Pusateri).
The Journal of the American Academy of Orthopaedic Surgeons
|December 3, 2025
概括
手术后的尿 (POUR) 影响了许多骨科患者,导致疼痛和并发症. 这项研究引入了一项新的基于证据的协议,以有效管理POUR,旨在降低患者的风险并改善康复.
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
- 患者管理 患者管理
背景情况:
- 手术后尿 (POUR) 在整形外科患者中很常见 (高达43%).
- 贫困会导致严重的并发症,包括疼痛,膀损伤,感染,增加成本和延迟康复.
- 目前的管理缺乏骨科文献中的标准化.
研究的目的:
- 提出一个结构化,以证据为基础的协议,用于管理骨科患者的术后尿 (POUR).
- 为骨科外科医生提供明确的指导方针,以基于时间和膀体积值来解决POUR.
- 减少POUR相关的并发症,改善患者的治疗结果,特别是在高风险人群中.
主要方法:
- 开发一个结合非侵入性技术,膀扫描,导管和泌尿器科咨询的协议.
- 协议侧重于干预的具体时间和膀体积值.
- 重点是解决患者和程序特定的风险因素.
主要成果:
- 拟议的议定书旨在规范POUR管理.
- 它指导及时干预,以促进自发排泄和预防并发症.
- 该协议旨在适用于高风险群体,包括儿科和老年患者.
结论:
- 一个标准化,基于证据的协议可以有效地管理骨科手术中的术后尿.
- 实施该协议可以减轻感染和膀损伤等风险.
- 这种结构化的方法支持更好的患者结果和治疗术后的康复手术.
相关概念视频
Urinary Tract Calculi VI: Surgical Management
335
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...
335
Urinary Tract Calculi V: Nursing Management
257
AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
257
Urinary Tract Calculi III: Medical Management
181
The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
181
Nursing Assessment of the Genitourinary System I: Health History
348
The genitourinary system is critical to maintaining fluid balance, waste elimination, and reproductive function. Nurses play a vital role in assessing this system, beginning with a thorough health history. This process involves gathering patient information, identifying risk factors, and recognizing symptoms of genitourinary disorders. Early detection is vital for timely interventions and management.1. Gathering Patient InformationA complete health history includes the patient’s personal,...
348
Nursing Assessment of the Genitourinary System II: Inspection and Palpation
696
The nursing assessment of the genitourinary (GU) system involves a systematic inspection and palpation to identify abnormalities in the kidneys, bladder, and surrounding structures.InspectionMouth: Inspect for signs of kidney dysfunction, such as stomatitis (inflammation of the mouth) and ammonia breath, which may occur in advanced kidney disease due to the buildup of urea, breaking down into ammonia.Skin: Check for pallor, which could indicate anemia caused by kidney disease. Look for...
696
Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations
353
Renal calculi, commonly termed kidney stones, are crystalline solid masses that form in the kidneys but can occur at any point within the urinary system, encompassing the kidneys, ureters, bladder, and urethra.The pathophysiology of renal stones involves several key factors: supersaturation of the urine with stone-forming constituents, changes in urine pH, a decrease in urine volume, and the presence of substances that promote or inhibit stone formation.Supersaturation of Urine: This is the...
353


