间歇性导尿术患者上尿路功能损害的相关因素分析  

Analysis for related factors of upper urinary tract deterioration in patients with intermittent catheterization

作　　者：罗璨[1] 张梦阳 刘佳蔚 陈忠[2] 许涛[1] LUO Can;ZHANG Mengyang;LIU Jiawei;CHEN Zhong;XU Tao(Department of Rehabilitation Medicine,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei 430030,P.R.China;Department of Urology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei 430030,P.R.China)

机构地区：[1]华中科技大学同济医学院附属同济医院康复医学科,武汉430030 [2]华中科技大学同济医学院附属同济医院泌尿外科,武汉430030

出　　处：《华西医学》2024年第6期872-877,共6页West China Medical Journal

基　　金：中国肢残人协会项目(2020098)。

摘　　要：目的 探讨社区采用间歇性导尿术的脊髓损伤患者发生上尿路功能损害(upper urinary tract deterioration, UUTD)的相关因素。方法 选择2020年8月3日—31社区脊髓损伤患者进行调查,并将其分为UUTD组和非UUTD组。比较两组在基本资料、间歇性导尿术操作特点及泌尿系统并发症方面的差异。采用logistic回归分析导致UUTD的危险因素。结果 共调查患者431例。其中,男性310例,女性121例;非UUTD组246例,UUTD组185例。两组的病程、性别、病因、尿失禁、尿路感染、膀胱结石与肾结石比较,差异均有统计学意义(P<0.05);其余指标两组间比较,差异均无统计学意义(P>0.05)。Logistic回归分析结果显示,尿路感染[比值比(odds ratio, OR)=3.229,95%置信区间(confidence interval, CI)(1.706,6.110),P<0.001]、肾结石[OR=4.846,95%CI(2.617,8.973),P<0.001]及尿失禁[OR=2.345,95%CI(1.116,4.925),P=0.024]是UUTD的危险因素。结论 尿路感染、肾结石和尿失禁是社区间歇性导尿术的脊髓损伤患者UUTD的独立危险因素,值得关注以采取预防策略。Objective To explore the related factors of upper urinary tract deterioration(UUTD)in spinal cord injury patients using intermittent catheterization(IC-SCI)in the community.Methods Patients with spinal cord injury in the Chinese community were selected for investigation between August 3 and August 31,2020.The included patients were divided into UUTD group and non-UUTD group.The basic information,intermittent catheterization practices,and urinary complications were compared between the two groups.Logistic regression was used to analyze the risk factors contributing to UUTD.Results A total of 431 patients were surveyed.Among them,there were 310 males and 121 females,246 cases in the non-UUTD group and 185 cases in the UUTD group.There were statistically significant differences in the disease duration,gender,etiology,urinary incontinence,urinary tract infection,bladder calculi and nephrolithiasis between the two groups(P<0.05);there was no statistically significant difference in the other indicators between the two groups(P>0.05).The results of logistic regression analysis showed that urinary tract infection[odds ratio(OR)=3.229,95%confidence interval(CI)(1.706,6.110),P<0.001],nephrolithiasis[OR=4.846,95%CI(2.617,8.973),P<0.001],and urinary incontinence[OR=2.345,95%CI(1.116,4.925),P=0.024]were risk factors for UUTD.Conclusion Urinary tract infection,nephrolithiasis and urinary incontinence are independent risk factors for UUTD in communitybased IC-SCI patients and deserve attention for preventive strategies.

关 键 词：上尿路功能损害 间歇性导尿 脊髓损伤 危险因素 

分 类 号：R473.6[医药卫生—护理学]