基于清洁间歇导尿术的自我护理在脊髓损伤后神经源性膀胱患者中的应用

Application of Self-care based on Clean Intermittent Catheterization in Patients with Neurogenic Bladder after Spinal Cord Injury

目的:探讨基于清洁间歇导尿术的自我护理在脊髓损伤后神经源性膀胱患者中的应用效果。方法:将86例脊髓损伤后神经源性膀胱患者按随机数字表法分为对照组和观察组各43例,对照组实施留置导尿法护理,观察组实施基于清洁间歇导尿术的自我护理。比较两组患者干预前、干预3个月后膀胱功能恢复情况,泌尿系统感染发生情况及生活质量量表(QOL)评分变化。结果:干预3个月后,观察组膀胱容量、膀胱压力均明显高于干预前,膀胱残余尿量明显低于干预前,且两组干预后组间比较差异有统计学意义( P <0.05);观察组泌尿系统感染发生率低于对照组( P <0.05);干预3个月后,两组患者QOL中生理领域、心理领域、主观感受、社会关系领域、环境领域评分均较干预前升高,且观察组高于对照组( P <0.05)。结论:脊髓损伤后神经源性膀胱患者应用基于清洁间歇导尿术的自我护理,有助于减少并发症,缓解膀胱功能障碍,改善患者预后。

Objective:To explore the application effect of self-care based on clean intermittent catheterization in patients with neurogenic bladder after spinal cord injury.Methods:A total of 86 cases of neurogenic bladder patients after spinal cord injury were divided into control group and observation group according to random number table method with 43 cases each.The control group was treated with indwelling catheterization,and the observation group was treated with self-care based on clean intermittent catheterization.Bladder function recovery,urinary tract infection and QOL score were compared before and 3 months after intervention between the two groups.Results:After 3 months of intervention,the bladder volume and pressure in the observation group were significantly higher than before intervention,and the bladder residual urine volume was significantly lower than before intervention.And the difference between the two groups after intervention was statistically significant( P <0.05).The incidence of urinary tract infection in the observation group was lower than that in the control group( P < 0.05).After 3 months of intervention,QOL scores in the physiological field,psychological field,subjective feeling,social relationship field and environmental field in the two groups all increased compared with those before nursing,and the observation group was higher than the control group( P <0.05).Conclusion:After spinal cord injury,patients with neurogenic bladder should adopt self-care based on clean intermittent catheterization,which is helpful to reduce complications,relieve bladder dysfunction and improve prognosis.