膀胱灌注透明质酸对脊髓损伤后复发性尿路感染的临床研究

Clinical research of effect of intravesical instillation of hyaluronate on recurrent urinary tract infections after spinal cord injury

目的探讨膀胱灌注透明质酸对脊髓损伤后复发性尿路感染的影响,寻求有效的治疗方法及治疗的安全性。方法选取2011年1月-2013年1月医院诊治的42例脊髓损伤后复发性尿路感染患者,随机分为对照组(呋喃西林)和观察组(透明质酸),每组各21例,治疗后对两组膀胱容量、残余尿量、菌尿、尿路感染率和生活质量(QOL)评分进行观察和比较;采用SPSS17.0软件进行统计分析,计量资料采用t检验,计数资料采用χ2检验。结果与对照组相比,治疗后观察组膀胱容量明显增大[(260.0±35.0)ml比(220.0±25.0)ml],残余尿量明显减少[(40.0±20.0)ml比(60.0±20.0)ml],菌尿无发热的发病率显著降低(44.4%比61.9%),QOL评分明显升高[(44.0±5.0)分比(35.0±4.0)分],两组比较差异有统计学意义(P<0.05)。结论对于脊髓损伤后复发性尿路感染患者,膀胱灌注透明质酸治疗的疗效显著,明显改善患者的生活质量,值得临床推广。

OBJECTIVE To explore the effect of intravesical instillation of hyaluronate on the recurrent urinary tract infections after the spinal cord injury so as to seek an effective treatment method to ensure the safety.METHODS Totally 42cases of spinal cord injury patients complicated with recurrent urinary tract infections,who were treated in the hospital from Jan 2011 to Jan 2013,were enrolled in the study and randomly divided into the control group（furacin）and the observation group（hyaluronate）,with 21cases in each;then the bladder capacity,residual urine volume,incidence of bacteriuria,incidence of urinary tract infections,and quality of life（QOL）were observed after the treatment and were compared between the two groups;the statistical analysis was performed with the use of SPSS17.0 software,the count data were analyzed by using the t-test,and the count data were analyzed through the chi-square test.RESULTS As compared with the control group,the blood capacity was significantly increased in the observation group after the treatment[（260.0±35.0）ml vs（220.0±25.0）ml],the residual urine volume was obviously decreased in the observation group[（40.0±20.0）ml vs（60.0±20.0）ml],the incidence of bacteriuria without fever was significantly reduced in the observation group（44.4% vs 61.9%）,and the QOL score was markedly increased in the observation group[（44.0±5.0）points vs（35.0±4.0）points],the differences between the two groups were significant（P0.05）.CONCLUSIONFor the patients with recurrent urinary tract infections after the spinal cord injury,the intravesical instillation of hyaluronate can achieve significant therapeutic effect and improve the quality of life of the patients markedly,which is worthy of clinical promotion.