自我清洁导尿术对神经源性膀胱患者储尿功能及并发症的影响  

Effect of self cleaning catheterization on urine storage function and complications of patients with neurogenic bladder

作　　者：胡晓燕[1] 张露[1] 陈婧[1] 龚桂芝[1] 宋波[1] 李龙坤[1] 

机构地区：[1]第三军医大学新桥医院泌尿外科,重庆400037

出　　处：《第三军医大学学报》2015年第6期515-518,共4页Journal of Third Military Medical University

基　　金：国家自然科学基金面上项目(81230017)~~

摘　　要：目的探讨神经源性膀胱患者行自我清洁导尿术对储尿功能及并发症的影响。方法对我院72例神经源性膀胱患者进行自我清洁术。对比研究患者自我清洁导尿术前后的并发症变化情况、尿动力学改变情况以及治疗的满意情况。结果患者在术后60 d的并发症情况较术前有显著降低(P<0.01),其中泌尿系感染发生率由58.33%降到26.39%(P<0.01),肾功能检查中尿素、肌酐、K+和尿酸较术前有较大的改善,其中尿素、肌酐和尿酸有统计学意义。患者尿动力学检测数据中,平均余尿量(PVR)、膀胱压(Pves)、膀胱容量(VH2O)均有下降,逼尿肌压力(Pdet)明显提高,括约肌协同失调(DSD)和膀胱低顺应性(BLG)比例下降(P<0.05)。在自我治疗的满意度评分中最高的为症状有所缓解,平均分为10分(总分10分);最低的为健康教育形式,仅为6.72分。结论自我清洁导尿术能够有效地降低神经源性膀胱患者泌尿系感染的发生率,改善患者的尿动力情况,提高了患者的生存质量,有利于神经源性膀胱患者的治疗康复。Objective To explore the effect of self cleaning catheterization on urine storage function and complications of patients with neurogenic bladder. Methods Seventy-two patients with neurogenic bladder in our hospital received self cleaning catheterization. The perioperative complications, urine dynamics and treatment satisfaction were analyzed before and after the catheterization. Results On the 60th day after continuous catheterization, the complications of the patients were decreased significantly, and the incidence of urinary tract infection were reduced from 58.33% to 26.39% （P 〈 0.01 ）. Except serum level of K ~ , blood urea, creatinine, and uric acid were significantly improved. Moreover, the urodynamics was improved significantly. The average residual urine volume （PVR）, bladder pressure （Pves）, and bladder capacity （Vs20） were decreased, while the detrusor pressure （Pdet） was increased significantly. The occurrences of detrusor-sphincter dyssynergia and low compliance bladder were significantly decreased （P 〈 0. 05 ）. The self treatment satisfaction scores showed improvements at different degrees. Conclusion Self cleaning catheterization may effectively reduce the incidence function, and increase the survival quality in patients the patients with neurogenic bladder. of urinary tract infection, improve the urine storage with neurogenic bladder, and is conducive to therapy of the patients with neurogenic bladder.

关 键 词：神经源膀胱 自我清洁 感染率 尿动力 满意度 

分 类 号：R195.4[医药卫生—卫生统计学] R694.5[医药卫生—卫生事业管理]