膀胱尿压测定评定系统在糖尿病神经源性膀胱护理中的应用

Application of the urinary bladder pressure measurement evaluation system in the nursing of diabetic neurogenic bladder

目的：观察膀胱尿压测定评定系统在糖尿病神经源性膀胱（ DNB ）护理中的应用效果。方法选择住院治疗的糖尿病神经源性膀胱患者50例，应用膀胱尿压测定评定系统了解膀胱压力容量变化、膀胱安全容量和最大容量、逼尿肌起始活动状态，括约肌状态、逼尿肌/括约肌协同能力，据此制订护理方案并实施，比较干预前后膀胱残余尿量及排尿功能变化。结果本组患者中尿失禁9例，尿潴留40例；膀胱训练后膀胱残余尿量＞200 ml患者从20例降至5例，中重度排尿功能障碍患者从22例降至7例，训练前后比较差异有统计学意义（U值分别为4．73，5．51；P＜0．01）。低顺应性小容量膀胱1例，转外科手术治疗。结论膀胱尿压测定评定系统用于糖尿病神经源性膀胱护理安全可行，可减少膀胱残余尿量，改善排尿功能。

Objective To observe the application effect of the urinary bladder pressure measurement evaluation system in the nursing of diabetic neurogenic bladder .Methods Fifty patients with diabetic neurogenic bladder two days after hospitalization from March 2011 to August 2013 were chosen .The change of bladder pressure and volume , the bladder safe capacity and maximum capacity , the starting activity state of detrusor, the state of sphincter, and the coordination ability of detrusor/sphincter were measured by the urinary bladder pressure meter .The nursing plan were made and carried out according to the results of measures .The residual urine volumes of bladder and the urination function changes were compared before and after the intervention .Results The cases of urinary incontinence （ high compliance small capacity bladder ） and the urinary retention （ high compliance large capacity bladder ） were respectively 9 and 40 cases.The cases of residual urine volumes of bladder more than 200 ml were decreased from 20 cases to 5 cases after the training of bladder , and the cases of patients with moderate and severe disorder of urination function were decreased from 22 cases to 7 cases after the training, and the differences were found before and after the training （U=4.73, 5.51, respectively;P〈0.01）.The case of low compliance small capacity bladder was one case , and was needed to the treatment of surgery .Conclusions Application of the urinary bladder pressure measurement evaluation system in the nursing of diabetic neurogenic bladder is safe and feasible , and can reduce the residual urine volumes of bladder , and improve the urination function .