脊髓损伤伴神经源性膀胱患者三元联动式延续性护理实践

The effects of Hospital-Community-Family continuous nursing care practice for patients with Spinal Cord Injury and Neurogenic Bladder

目的:评价"医院-社区-家庭"三元联动延续性护理模式在脊髓损伤(SpinalCordInjury,SCI伴神经源性膀胱(NeurogenicBladder,NB)患者膀胱功能康复训练中的应用效果。方法:选取SCI伴NB住院患者80例,其中2015年1月至2016年12月的40例患者为对照组,2017年1月至2018年12月的40例患者为观察组。对照组采用传统的延续性护理模式,观察组采用医院-社区-家庭延续性护理模式。结果:观察组患者间歇性导尿执行正确率、饮水计划执行的依从率、排尿日记持续7天记录执行率、恢复自主排尿患者比例优于对照组(P<0.01),泌尿系统并发症发生率低于对照组(P<0.01)。结论:医院-社区-家庭三元联动式延续性护理实践可为SCI后NB患者建立规范的膀胱训练方法,降低并发症的发生,最大限度恢复自主排尿,提高患者生活质量。

Objective:To explore the effects of Hospital-Community-Family ternary linkage nursing model in the rehabilitation training of patients suffered from Spinal Cord Injury(SCI)accompanying with Neurogenic Bladder.Methods:The Hospital-Community-Family management team consists of the hospital education group,community nurses and the home care nurses.From the orthopedic apartment of one hospital,80 patients suffered from SCI with NB were selected.Totally 40 patients were included in the control group,treated with traditional nursing care.The other 40 patients were included in the observation group,treated with new nursing model.Results:There were significant differences between the two groups in the accuracy of intermittent catheterization execution,the compliance of drinking plan execution,the execution rate of recording urination diary for 7 continuous days in control and the number of patients who resumed spontaneous urination respectively(P<0.01).The incidence of urinary complications were significantly lower in the observation group than the control group(P<0.01).Conclusion:Hospital-Community-Family ternary linkage continuous nursing care enabled patients who suffered from SCI and NB to build up more specified bladder training methods,reduce the incidence of complications,maximize the recovery of spontaneous urination and improve the patients’quality of life.