按需膀胱冲洗在脊髓损伤致神经源性膀胱患者中的应用效果

The application effect of on-demand bladder irrigation in patients with neurogenic bladder caused by spinal cord injury

目的探讨按需膀胱冲洗在脊髓损伤致神经源性膀胱患者中的应用效果。方法选取2018年9月至2019年3月我院70例脊髓损伤致神经源性膀胱患者作为研究对象,按入院先后顺序等分为对照组和干预组。两组患者均采用间歇导尿术。对照组:膀胱冲洗每周2次,如果肉眼发现尿液中有沉淀物、絮状物或尿液有异味时,则冲洗次数增加为每日1次,直至肉眼观察尿液清亮、无异味为止。干预组:尿液正常情况下无需冲洗,当尿液中有沉淀物、絮状物或尿液有异味时冲洗,冲洗频率为每日1次,直至肉眼观察尿液清亮、无异味为止。比较两组患者尿路感染发生率及人均总医疗费用。结果在治疗12周期间,干预组人均总医疗费用低于对照组(P<0.05),两组患者尿路感染发生率比较差异无统计学意义(P>0.05)。结论在脊髓损伤致神经源性膀胱患者中应用按需膀胱冲洗可获得较好的疗效,减轻患者家庭经济负担,值得临床推广应用。

Objective To explore the application effect of on-demand bladder irrigation in patients with neurogenic bladder caused by spinal cord injury.Methods To select 70 cases of patients with neurogenic bladder caused by spinal cord injury in our hospital from September 2018 to March 2019 as the study objects.They were divided into a control group and an intervention group according to the order of admission.Both groups of patients used intermittent catheterization.The bladder was washed twice a week in the control group,if the urine was found to have sediments,flocs or urine odor,the number of rinsing was increased to once a day until the urine was clear and no smell,and the urine does not need to be rinsed under normal circumstances in the intervention group,when there was sediment,flocs or urine odor in the urine,the rinsing frequency was increased once a day until the urine was clear and no odor is observed.The incidence of urinary tract infection and total medical expenses per capita were compared between the two groups.Results During the 12 weeks of treatment,the total medical expenses per capita in the intervention group was lower than that in the control group(P<0.05).There was no significant difference in incidence of urinary tract infection between the two groups(P>0.05).Conclusion The application of on-demand bladder irrigation in patients with neurogenic bladder caused by spinal cord injury could obtain better efficacy and reduce the family's economic burden,which was worthy of clinical promotion and application.