运动想象疗法治疗脊髓损伤神经源性膀胱患者的影响因素分析

Influencing factors analysis on using active imagery therapy in spinal cord injury patients with neurogenic bladder

目的：探求运用运动想象疗法治疗脊髓损伤神经源性膀胱患者的影响因素。方法将入组92例应用运动想象疗法进行膀胱功能训练的脊髓损伤神经源性膀胱患者,根据其训练效果是否明显分为两组,分别观察包括年龄、文化程度、康复介入时机、脊髓损伤类型等在内的11项可能影响训练效果的因素,使用Logistic回归分析影响疗效的因素。结果患者的文化程度、抑郁状态、神经源性膀胱类型、介入时间及坚持疗程不同会影响患者进行膀胱训练,差异有统计学意义（χ^2值分别为5.851,6.903,6.901,30.597,4.211；P〈0.05）。大专以下文化程度、HAMD≥17分、介入时间≥60 d、坚持疗程〈8周及神经源性膀胱类型为尿失禁是应用运动想象疗法对脊髓损伤神经源性膀胱患者进行膀胱训练时的不利影响因素。结论文化程度、抑郁状态、康复介入时机、坚持疗程、神经源性膀胱类型是应用运动想象疗法对脊髓损伤神经源性膀胱患者进行膀胱训练时的影响因素,在进行运动想象疗法训练时应针对这些影响因素加强宣教指导。

Objective To investigate the influencing factors of using active imagery therapy in spinal cord injury patients with neurogenic bladder. Methods Ninety-two spinal cord injury patients were arranged for bladder function training by active imagery therapy. According to the training effect, they were divided into two groups, and a total of eleven factors were observed including age, education level, time of rehabilitation intervention, the type of spinal cord injury and etc. The logistic regression was used to analyze the possible influence factors of the two groups. Results The analysis results indicated that there were significant differences in education level, depression state, the type of neurogenic bladder, rehabilitation time and course of treatment which were affect the bladder training （χ^2=5. 851, 6. 903, 6. 901, 30. 597, 4. 211,respectively;P〈0. 05）. The results showed that below the junior college level, HAMD≥17, time of rehabilitation intervention≥60 d, treatment course 〈8 weeks, incontinence of urine were the adverse factors. Conclusions Education level, depressive state, time of rehabilitation intervention, treatment course, type of neurogenic bladder were the prognostic factors in spinal cord injury patients who was arranged for bladder function training by active imagery therapy. Aiming at these factors, medical staff should provide necessary guidance to improve the results of treatment.