脊髓损伤神经源性膀胱住院患者间歇导尿应用情况调查

Application of intermittent catheterization in patients with neurogenic bladder caused by spinal cord injury:A questionaire survey study

目的调查脊髓损伤神经源性膀胱住院患者间歇导尿应用现状,进一步规范该类患者的膀胱功能管理,提高间歇导尿应用率,降低泌尿系感染发生率。方法应用自制调查问卷对解放军总医院第一附属医院2015年7—10月80例脊髓损伤神经源性膀胱患者进行间歇导尿应用情况调查。结果 80例中,男性68例、女性12例,年龄20～74（38.63±11.40）岁,农民37例、工人30例、其他13例,自费医疗44例、医保及保险36例;脊髓损伤早期（伤后1个月内）采用间歇导尿法14例（17.5%）中泌尿系感染4例,其他排尿方式（留置导尿、叩击）感染发生率为78.95%;恢复期采用间歇导尿70例（87.5%）中泌尿系感染12例,其他排尿方式感染发生率为60%。间歇导尿脊髓损伤神经源性膀胱患者较其他排尿方式（留置导尿、叩击）同类患者泌尿系感染发生率低（P〈0.05）。结论间歇导尿可明显降低脊髓损伤神经源性膀胱患者泌尿系感染发生率。

Objective To investigate the application of intermittent catheterization in patients with neurogenic bladder caused by spinal cord injury, then standardize the management of bladder function in these patients, improve the utilization rate of intermittent catheterization, and reduce the incidence of urinary tract infection. Methods The application of intermittent catheterization in 80 patients with neurogenic bladder due to spinal cord injury were investigated using self-made questionnaire from July to October in 2015 in the First Affiliated Hospital of Chinese PLA General Hospital. Results Of the 80 patients, there were 68 males and 12 females with age ranging from 20 to 74 years [average age of（38.63±11.40） years]. There were 37 peasants, 30 workers and others accounting for 13, 44 patients were self-paying and 36 patients were paid by insurance. Of these patients, 14（17.5%） cases had received intermittent catheterization in early stage（within 1 month after spinal cord injury） of spinal cord injury with 4 cases having urinary tract infection, while the urinary infection rate of other methods（indwelling catheterization, tapping） was 78.95%; 70（87.5%） cases had received intermittent catheterization in the recovery stage with 12 cases having urinary tract infection, while the urinary infection rate of other methods（indwelling catheterization, tapping） was 60%. Compared with other bladder emptying modalities, intermittent catheterization showed lower incidence of urinary tract infection in patients with neurogenic bladder due to spinal cord injury（P〈0.05）. Conclusion Intermittent catheterization can obviously reduce the incidence of urinary tract infection in the managment of neurogenic bladder in patients with spinal cord injury.