[email protected]

当代护理

Contemporary Nursing

您当前位置：首页 > 精选文章

Contemporary Nursing. 2026; 7: (5) ; 10.12208/j.cn.20260232 .

Exploration of the application of tetracaine hydrochloride mucilage in urethral catheterization before TACE
盐酸丁卡因胶浆在TACE术前导尿中的应用探讨

作者： 李文燕, 白敏娜 *

中山大学附属第六医院介入科 广东广州

*通讯作者： 白敏娜,单位：中山大学附属第六医院介入科 广东广州; ；

引用本文: 李文燕, 白敏娜 盐酸丁卡因胶浆在TACE术前导尿中的应用探讨[J]. 当代护理, 2026; 7: (5) : 9-12.
Published: 2026/5/7 9:10:00

摘要

目的 评价盐酸丁卡因胶浆在我院肝动脉化疗栓塞术（TACE）患者术前导尿中的镇痛、黏膜保护效果及加速康复价值。方法 采用回顾性对照设计，收集2025年7至11月我院介入病房拟行TACE的患者，按预先设定的纳入和排除标准选取研究对象，共61人，分为盐酸丁卡因胶浆研究组（46例）与石蜡油对照组（15例）。两组评估的主要观察指标为视觉模拟评分（VAS）、24h内尿路刺激症状发生率、一次性置管成功率及不良反应；次要指标包括操作时间、患者满意度、住院天数及ERAS依从性。结果 研究组导尿瞬间VAS（2.3±0.8）分、5min 后（1.5±0.6）分，分别低于对照组（6.8±1.2）分与（5.2±1.0）分，差异有统计学意义（t=15.623、16.345，P＜0.001）。24 h内尿路刺激症状发生率研究组10.9 %，对照组53.3 %（χ²=15.289，P＜0.001）。一次性置管成功率研究组95.7 %，对照组60.0 %（χ²=13.672，P＜0.001）。平均操作时间研究组（2.4±0.5）min，对照组（4.1±0.9）min（t=8.417，P＜0.001）。患者满意度评分研究组（9.2±0.6）分，对照组（6.8±1.1）分（t=9.305，P＜0.001）。住院天数、住院费用两组差异无统计学意义（P＞0.05）。不良反应：对照组1例轻微心悸，研究组未见明显不良反应，差异无统计学意义（P=0.571）。结论 相比较常规的石蜡油来说，盐酸丁卡因胶浆可显著减轻TACE患者术前导尿疼痛，降低尿路刺激，提高置管效率与患者满意度，契合加速康复外科（ERAS）理念，安全可行，值得临床推广应用。

关键词： 盐酸丁卡因胶浆；导尿术；加速康复外科（ERAS）理念；肝动脉化疗栓塞术（TACE）；疼痛管理

Abstract

Objective To evaluate the analgesic and mucosal-protective effects and enhanced-recovery value of tetracaine hydrochloride jelly for preoperative urethral catheterization in TACE patients.
Methods This retrospective controlled study enrolled 61 consecutive TACE candidates from our interventional unit (July–November 2025), allocated to tetracaine hydrochloride jelly (n=46) or liquid paraffin (n=15) per preset inclusion/exclusion criteria. Primary endpoints were visual analogue scale (VAS) score, 24h urinary irritative symptom incidence, first-attempt success rate, and adverse events; secondary endpoints included procedure time, patient satisfaction, length of stay, and ERAS compliance.
Results Study group VAS scores at catheterization (2.3±0.8 vs 6.8±1.2) and at 5min (1.5±0.6 vs 5.2±1.0) were significantly lower (t=15.623 and 16.345; P<0.001). The 24h urinary irritative symptom incidence was 10.9% vs 53.3% (χ²=15.289, P<0.001). First-attempt success rate was 95.7% vs 60.0% (χ²=13.672, P<0.001). Mean procedure time was 2.4±0.5min vs 4.1±0.9min (t=8.417, P<0.001). Patient satisfaction scores were 9.2±0.6 vs 6.8±1.1 (t=9.305, P<0.001). Length of stay, costs, and adverse events showed no significant differences (P>0.05; one control patient reported mild palpitations vs none in study group, P=0.571).
Conclusion   Compared with conventional liquid paraffin, tetracaine hydrochloride jelly significantly reduces catheterization pain and urinary irritation, improves procedural efficiency and patient satisfaction, aligns with ERAS principles, and is safe for routine clinical use.

Key words： Tetracaine hydrochloride gel; Urethral catheterization; Enhanced recovery after surgery (ERAS); Transarterial chemoembolization (TACE); Pain management

参考文献 References

[1] 张敏, 李幼平. 导尿术相关疼痛的评估与干预[J]. 中华护理杂志, 2023, 58(3): 310-315.

[2] 中国抗癌协会肝癌专业委员会. 肝动脉化疗栓塞术治疗肝癌中国专家共识(2024 版)[J]. 中华消化外科杂志, 2024, 23(1): 1-12.

[3] 王芳, 等. 石蜡油润滑剂致男性尿道损伤的临床分析[J]. 中国男科学杂志, 2022, 36(4): 45-48.

[4] 陈孝平, 汪建平. 外科学[M]. 9 版. 北京: 人民卫生出版社, 2021: 898-900.

[5] Ljungqvist O, Scott M, Fearon K C. Enhanced Recovery After Surgery: A Review[J]. JAMA Surg, 2023, 158(2): 189-198.

[6] 国家药典委员会. 中华人民共和国药典: 二部[S]. 2025 年版. 北京: 中国医药科技出版社, 2025: 1634-1635.

[7] 刘洋, 等. 羧甲基纤维素钠凝胶润滑机制的表面力学研究[J]. 功能材料, 2021, 52(12):12128-12133.

[8] Tønseth K A, et al. Tetracaine gel for pain relief during flexible cystoscopy: a randomized, double-blind, placebo-controlled trial[J]. Scand J Urol, 2022, 56(2): 123-128.

[9] Lee J H, et al. Topical tetracaine reduces pain during transrectal prostate biopsy: prospective randomized study[J]. Urology, 2020, 145: 182-187.

[10] 赵倩, 等. 盐酸丁卡因胶浆在男性导尿术中的应用效果[J]. 护理研究, 2023, 37(10): 1789-1792.

[11] Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation[J]. Br J Anaesth, 2021, 126(3): 583-589.

[12] ERAS® Society. Guidelines for perioperative care in interventional radiology[J]. World J Surg, 2024, 48(1): 1-15.

[13] Covino B G. Pharmacology of local anesthetic agents[J]. Int Anesthesiol Clin, 2020, 58(4): 1-11.

[14] 周伟, 等. 医用高分子润滑凝胶的摩擦学性能评价[J]. 中国医疗器械杂志, 2022, 46(5): 456-460.

[15] Hooton T M. Clinical practice: catheter-associated urinary tract infection[J]. N Engl J Med, 2021, 385(14): 1283-1291.

[16] Chen Y, et al. Tetracaine gel vs lidocaine gel for cystoscopy: systematic review and network meta-analysis[J]. J Endourol, 2023, 37(8): 1021-1028.

[17] 郭应禄, 周利群. 泌尿外科导尿并发症防治[M]. 北京: 北京大学医学出版社, 2019: 55-60.

[18] Butterworth J F, Mackey D C, Wasnick J D. Morgan & Mikhail’s Clinical Anesthesiology[M]. 7th ed. New York: McGraw-Hill, 2022: 258-260.