无菌间歇导尿对脊髓损伤尿潴留患者恢复自主排尿功能的影响

Effect of Intermittent Catheterization on Recovery of Automatic Micturition in Spinal Cord Injury Patients with Urinary Retention

目的探讨无菌间歇导尿与常规留置尿管行膀胱训练对脊髓损伤尿潴留患者排尿功能的影响。方法将67例脊髓损伤尿潴留患者分为对照组和观察组,对照组33例采用传统的留置尿管下膀胱训练方法,观察组34例采用拔除尿管间歇导尿方法,2个月后分析两组患者恢复自主排尿时间、残余尿量、每日自排尿量及泌尿系感染发生率。结果观察组患者较对照组恢复自主排尿时间早,残余尿量少,每日自排尿量多,泌尿系感染发生率低,差异均有统计学意义。结论对于脊髓损伤尿潴留患者损伤4周后即使未出现拔管指征,也可以将尿管拔除采用间歇导尿的方法继续训练膀胱功能,间歇导尿可使患者较快地恢复自主排尿功能,减少残余尿量,增加每日自主排尿量,降低泌尿系感染发生率。

Objective To compare the effect of sterile intermittent catheterization with traditional bladder training for the recovery of urinary function in spinal cord injury patients with urinary retention. Methods A total 67 patients with urinary retention were randomly divided into experiment group with intermittent catheterization after extraction of indwelling catheter （n=34） and control group with traditional bladder training with indwelling catheter （n=33）. Days of automatic micturition, bladder post-void residual volume, daily automatic urine volume, and urinary infection rate were compared after 2 months. Results Patients in experiment group had less days of automatic urine, less bladder post-void residual volume, more daily automatic urine volume, and lower infection rate than those in control group. Conclusion Spinal cord injury patients with urinary retention could receive intermittent catheterization 4 weeks later even without sign of extraction of indwelling catheter. Intermittent catheterization benefits patients＇ early recovery of automatic urine and could decrease post-void residual volume and infection rate while increase daily automatic urine volume.