社区脊髓损伤者应用间歇导尿的现状及影响因素

Investigation on the use of intermittent catheterization and related influence factors in community patients with spinal cord injury

目的通过对社区脊髓损伤神经源性膀胱功能障碍者应用间歇导尿的现状及影响因素的调查,为康复专科护士制订规范间歇导尿方法及实施康复护理提供帮助。方法选择社区2010年9月—2011年12月诊断为脊髓损伤神经源性膀胱功能障碍者76例进行调查,内容包括一般资料、间歇导尿应用情况和影响因素。结果 76例患者中,48.7%排尿方式采用留置导尿;21.6%采用叩击或腹压排尿;5.3%采用间歇导尿。影响间歇导尿应用的主要因素:92.1%担心引发尿路感染;88.2%担心增加尿道损伤概率;82.9%认为留置导尿比间歇导尿经济,长期间歇导尿耗材费用增加;69.7%认为间歇导尿操作麻烦;65.8%缺乏专业医务人员的指导;56.6%认为脊髓损伤无法恢复而安于现状;21.1%对腹压排尿的危害不了解。结论康复专科护士应根据影响脊髓损伤者应用间歇导尿的主要因素,制订合适的健康教育和间歇导尿操作规范,提高患者正确应用间歇导尿的认知状态,有利于患者正确使用间歇导尿,减少并发症的发生,提高患者的生活质量。

Objective To investigate the use of intermittent catheterization and related influence factors in com- munity patients with neurogenie bladder in spinal cord injury, and provide the basis for formulating intermittent catheterization standard. Methods A total of 76 community patients with neurogenic bladder in spinal cord in- jury were selected from September 2010 to December 2011. They were investigated by a questionnaire about the use of intermittent catheterization and related influence factors. Results In 76 patients, 48.7% employed in- dwelling catheterization; 21.6% employed tapping or abdominal pressure urination; and 5.3% employed inter- mittent catheterization. The main factors affecting intermittent catheterization application were listed as follows： 92.1% worried about the infection of urinary tract; 88.2% worried about increase in probability of urethral damage ; 82. 9% considered that indwelling catheterization was cheaper than intermittent catheterization; 69.7% had trouble in intermittent catheterization operation; 65. 8% lacked medical professional＇s guide; 56.6% considered that spinal cord injury could not recover; and 21.1% had no idea of the dangers of abdomi- nal pressure urination. Conclusion The rehabilitation nurses should formulate intermittent catheterization standard according to the main influence factors, and improve the patients＇ cognition and right use, to reduce complications and improve their life quality.