关键词: 颅脑手术, 移除尿管时间, 尿管重置率, 下肢深静脉血栓

Abstract: Objective To investigate the effect of urinary catheter removal timing on the rate of recatheterization in patients undergoing intracranial surgeries, identify the optimal timing of postoperative catheter removal, and reduce complications associated with prolonged bed rest. Method A retrospective analysis was conducted on the clinical data of 444 patients who underwent neurosurgery and received indwelling urinary catheterization between November 2022 and December 2025. Patient data were retrieved and recorded via the medical record system, nursing information system, radiological imaging system, B-mode ultrasound system, and laboratory system. Based on the duration of catheterization, patients were divided into three groups： Group 1, catheter removal on postoperative day 1, Group 2, removal on postoperative days 2~5, and Group 3, removal on postoperative day ≥6. We used group 1 as the reference, and performed logistic regression models to evaluate the associations of catheter removal timing with urinary recatheterization, and lower-extremity deep vein thrombosis. Results A total of 444 patients were included: 196 in Group 1, 155 in Group 2, and 93 in Group 3. The recatheterization rates in Groups 1, 2, and 3 were 3.57%, 5.81%, and 22.58%, and the incidences of lower-extremity deep vein thrombosis （DVT） were 4.08%, 8.39%, and 33.33%, respectively. Bonferroni-corrected pairwise comparisons showed that both outcomes were more frequent in Group 3 than in Groups 1 and 2 （all P<0.001）, whereas neither outcome differed significantly between Groups 1 and 2 （both P>0.017）. In fully adjusted logistic regression models with Group 1 as the reference, catheter removal on or after postoperative day 6 （Group 3） was independently associated with higher odds of recatheterization （OR=6.758, 95%CI： 2.696~18.765） and DVT （OR=11.222, 95%CI： 4.601~30.306） （both P<0.001）, whereas removal on postoperative days 2~5 （Group 2） was not significantly associated with either outcome （P=0.441 and 0.102, respectively）. When removal timing was analyzed as a continuous variable, each 1-day delay in catheter removal was associated with adjusted ORs of 1.096 （95%CI： 1.055~1.145） for recatheterization and 1.055 （95%CI： 1.020~1.094） for DVT. Conclusion Later catheter removal was associated with higher risks of recatheterization and lower-extremity DVT, particularly when the catheter was removed on or after postoperative day 6.

Key words: neurosurgery, urinary catheter removal timing, recatheterization rate