简易测压法测量脊髓损伤病人不同容量状态下膀胱压力的可行性研究  

Feasibility Study of Simple Manometry for Determining Bladder Pressure in Different Fillings of Patients with Spinal Cord Injury

作　　者：阳世伟[1] 孙其凤[1] 龚敏[1] 李金霞[1] 

机构地区：[1]深圳市第二人民医院,广东深圳518035

出　　处：《护理学报》2009年第19期1-4,共4页Journal of Nursing（China）

基　　金：深圳市科技局立项课题(200304066)

摘　　要：目的探讨护士用简易测压法测量脊髓损伤（spinal cordinjury,SCI）病人不同容量状态下膀胱压力的可行性,以便为膀胱潮式引流提供依据。方法对2003年11月—2007年5月33例SCI病人分别采用简易测压法与尿动力学监测仪测量法测量其膀胱压力,简易测压法为参照早年没有压力传感器时,通过持续灌注与间断测压由水压计测得压力的方法,测量时间从术后第2周开始,每周1次,连续测量3次,尿动力学监测仪测量方法于术后3～4周到尿动力室进行膀胱压力测量1次。比较两种方法测量值并分析其相关性,记录所测病人膀胱压力随容量、体位及排尿状态变化的变化趋势。结果两种方法测量病人不同膀胱容量状态下膀胱压力值差异无统计学意义（P〉0.05）,两结果相关性分析结果显示r值为0.78-0.94（P〈0.05）;SCI病人膀胱压力随容量增加逐步升高,膀胱容量在350 ml（约10 cmH2O）以内时,膀胱内压力变化曲线相对平缓,而在350 ml以上时膀胱内压力变化明显;半坐卧位膀胱内压力高于平卧位。结论简易测压法在一般医院缺乏床旁B超协助诊断膀胱内容量时,代替尿动力学监测仪测压法用于SCI病人膀胱容量变化的测量有一定的可行性,临床护士可将平卧位时10～13 cmH2O（1cmH2O=0.098 kPa）作为潮式引流的放尿压,病人取半坐卧位时,应将膀胱内放尿压调整为13～18 cmH2O;且病人取半坐卧位训练膀胱功能优于平卧位,可帮助护士正确指导SCI病人的卧床排尿训练,值得在临床推广应用。Objective To explore the feasibility of simple manometry for determining the bladder pressure in different fillings of patients with spinal cord injury （SCI）, so as to provide the basis for bladder tidal drainage. Methods 33 SCI cases were, respectively, offered the bladder pressure testing by means of simple manometry and urodynamic monitor. Simple manometry tests started 2 weeks after the surgery, once a week for 3 running weeks, and the test by means of urodynamic monitor was done 3 to 4 weeks after the surgery once. A comparison was made of the values obtained through the two test means and an analysis was made of the correlationship. The tendency of change in the bladder pressure as the filling, body posture and urination state change was also recorded. Results The bladder pressure values by the two testing means had no statistically significant difference （P〉0.05）, and as suggested by the correlation analysis, r was 0.78-0.94（P〈0.05）. The bladder pressure of SCI patients rose with the increase in the fillings, with the pressure change curve going relatively smoothly when the filling is within 350 ml （about 10 cmH2O） while sharply when it was above 350 ml. And the bladder pressure was higher when the patients were in the semi-sitting-lying position than when they were in the lying position. Conclusion Simple manometry testing is, in absence of bedside B-ultrasonic assistance, feasible as a replacement of urodynamic monitor testing in determining the bladder pressure of SCI patients.

关 键 词：脊髓损伤 简易测压法 膀胱容量 膀胱压力 尿动力 

分 类 号：R47[医药卫生—护理学]