膀胱安全容量导尿法对骶上脊髓损伤患者下尿路功能的影响  

Effect of Safety Bladder Capacity Catheterization on Lower Urinary Tract Function in Patients With Suprasacral Spinal Cord Injury

作　　者：张大伟[1] 朱红军[1] 冯晓燕 陈玉红[1] 刘怡 陈康武[2] 蔡萍[1] ZHANG Da-wei;ZHU Hong-jun;FENG Xiao-yan;CHEN Yu-hong;LIU Yi;CHEN Kang-wu;CAI Ping(Department of Rehabilitation Medicine,the First Affiliated Hospital of Soochow University,Suzhou,Jiangsu 215006,China;Department of Orthopedics,the First Affiliated Hospital of Soochow University,Suzhou,Jiangsu 215006,China)

机构地区：[1]苏州大学附属第一医院康复科,江苏苏州市215006 [2]苏州大学附属第一医院骨外科,江苏苏州市215006

出　　处：《中国康复理论与实践》2021年第6期692-697,共6页Chinese Journal of Rehabilitation Theory and Practice

基　　金：国家自然科学基金青年基金项目(No.81802682)。

摘　　要：目的评估依据膀胱安全容量行间歇性导尿对骶上脊髓损伤患者下尿路功能的影响。方法 2019年1月至12月选取本院骶上脊髓损伤后下尿路功能障碍患者60例,随机分为对照组(n=30)和观察组(n=30)。对照组行间歇性导尿,导尿频率依据残余尿。观察组行间歇性导尿,导尿频率依据膀胱安全容量。比较两组最大逼尿肌压、残余尿、膀胱安全容量、尿路感染情况和逼尿肌厚度。结果治疗8周后,观察组最大逼尿肌压、残余尿减少,膀胱安全容量显著增加(t> 5.623, P <0.05),且均优于对照组(t> 2.242, P <0.05);逼尿肌厚度显著降低(t=7.871, P <0.05),且明显低于对照组(t=3.049, P <0.01),尿路感染次数少于对照组(χ^(2)=4.320, P=0.038)。结论依据膀胱安全容量行间歇性导尿,可以改善骶上脊髓损伤患者下尿路功能。Objective To evaluate the effect of safety bladder capacity catheterization on lower urinary tract function in patients with supracacral spinal cord injury.Methods A total of 60 patients with lower urinary tract dysfunction after suprasacral spinal cord injury in our hospital from January to December,2019 were divided into control group(n=30)and observation group(n=30)randomly.Both groups were given intermittent catheterization,the frequency of catheterization was determined according to postvoid residual volume in the control group,while it was according to safety bladder capacity in the observation group.Their maximum destrusor pressure,postvoid residual volume,safety bladder capacity,urinary tract infection and detrusor wall thickness were compared.Results Eight weeks after intervention,the maximum destrusor pressure and postvoid residual volume decreased,and the safety bladder capacity increased in the observation group(t>5.623,P<0.05),and were better than that of the control group(t>2.242,P<0.05);the detrusor wall thickness significantly decreased in the observation group(t=7.871,P<0.05),and was lower than that of the control group(t=3.049,P<0.01).The number of urinary tract infection patients was less in the observation group than in the control group(χ^(2)=4.320,P=0.038).Conclusion Intermittent catheterization based on safety bladder capacity can improve lower urinary tract function in patients with suprasacral spinal cord injury.

关 键 词：脊髓损伤 间歇性导尿 膀胱安全容量 

分 类 号：R651.2[医药卫生—外科学]