间歇导尿术在脊髓损伤致神经源性膀胱中的心理影响

Psychological Influence of the Intermittent Urethral Catheterization for Neurogenic Bladder after Spinal Cord Injury

目的:探讨间歇导尿术在脊髓损伤引起的神经源性膀胱中的心理影响,同时对患者进行密切随访,了解患者远期的心理健康状况。方法:选择本院2010年12月-2014年12月收治的22例脊髓损伤(SCI)患者为研究对象,根据入院顺序随机将其分为试验组11例和对照组11例,住院期间密切关注患者病情和心理变化,制定详细的饮水和护理计划,试验组采用间歇导尿术,对照组采用留置导尿术,试验前后试验组与对照组均行ADL评估及国际通用的症状自评量表(SCL-90)评估。结果:随访2个月后,试验组的ADL评分明显高于对照组,差异有统计学意义(P<0.05);SCL-90评分方面,试验组与对照组患者治疗后在焦虑、抑郁及人际关系三项症状上均较治疗前有所改善,且试验组改善情况优于对照组,比较差异均有统计学意义(P<0.05)。结论:间歇导尿术能提高脊髓损伤患者日常生活能力,降低患者的焦虑、抑郁情绪,改善人际关系,采取正确的清洁间歇导尿方法在减少患者不便和难堪的同时,减轻患者心理负担,有利于患者更好的回归社会,回归家庭,具有重要的临床意义。

Objective： To explore the psychological effects of intermittent urethral catheterization on neurogenic bladder patients caused by spinal cord injury, and to understand the long-term mental health status of patients by following up closely.Method： Twenty-two spinal cord injury patients admitted to our hospital from December 2010 to December 2014 were selected as the objects and derided into the control group and the experimental group, 11 patients in each group.The patients＇ condition and psychological changes were closely observed during hospitalization, and a detailed schedule for drinking water and nursing was made before and after the experiment.The experimental group was treated with intermittent catheterization, while the control group was given indwelling catheterization, the experimental group and the control group were evaluated by ADL assessment and international general symptom checklist（SCL-90） assessment. Result： After two months＇ followed-up, the ADL scores of the experimental group was significantly higher than that of the control group, the difference was statistically significant（P〈0.05） ; As to the SCL-90 assessment, both of the two groups were significantly improved in anxiety, depression and interpersonal relationship, and the experimental group was better than the control group, the differences were statistically significant（P〈0.05）.Conelusion： The intermittent catheterization is beneficial to improve the ability of daily life of patients, which reduces the anxiety and depression of patients and improve their interpersonal relationship.Adopting clean intermittent catheterization in the right ways can reduce patients＇ inconvenience, embarrassment, and the mental burden, it is also helpful for patients to return to society and family, and it has an important clinical significance.