新型压力监测设备在导尿患者膀胱锻炼的应用

Application of New Pressure Monitoring Equipment in Bladder Exercise of Patients with Catheterization

目的探讨一种新型膀胱压力监测设备在留置尿管患者膀胱功能锻炼中的应用,为留置尿管患者的膀胱管理提供一种新方法。方法选取笔者医院2019年7月~2020年3月留置尿管患者超过3天的患者71例,按是否使用新型膀胱压力监测设备进行膀胱锻炼进行分组,并对结果进行分析。再按拔管结果分为两组,以拔除导尿管是否成功为因变量,以有统计学意义的临床指标为自变量,用Logistic回归分析对拔管成功的影响。结果对照组和锻炼组患者的年龄、性别、APACHEⅡ评分、ALB、合并慢性病和导管相关性感染情况比较,差异无统计学意义(P>0.05)。对照组患者的留置导管时间、48h重新插管率、ICU滞留天数高于锻炼组,拔管成功率低于锻炼组,差异有统计学意义(P<0.05)。拔管成功组患者的ALB、锻炼率高于拔管失败组,APACHEⅡ评分低于拔管失败组,差异有统计学意义(P<0.05)。以拔管失败情况为因变量,以差异有统计学意义的APACHEⅡ评分、ALB和锻炼情况等3项指标为自变量,多元Logistic回归分析结果显示,APACHEⅡ评分高(OR=1.276)、未进行锻炼(OR=3.867)是拔管失败的危险因素,差异有统计学意义(P<0.05)。结论使用新型膀胱压力监测设备进行膀胱锻炼的留置导管时间、48h重新插管率、ICU滞留天数更低,拔管成功率更高,导管相关性感染率比较差异无统计学意义。

Objective To explore the application of a new bladder pressure monitoring device in the exercise of bladder function of patients with indwelling catheter,and to provide a new method for bladder management of patients with indwelling catheter.Methods From July 2019 to March 2020,71 patients with indwelling catheter for more than 3 days were selected and grouped according to whether to use the new bladder pressure monitoring equipment for bladder exercise,and the results were analyzed.According to the results of extubation,the patients were divided into two groups.The dependent variable was the success of extubation,the independent variable was the statistically significant clinical indicators,and the influence of the success of extubation was analyzed by Logistic regression.Results There was no significant difference in age,gender,APACHEⅡscore,ALB,chronic disease and catheter-related infection between the control group and exercise group(P>0.05).The time of indwelling catheter,the rate of re intubation in 48 hours and the days of staying in ICU in the control group were higher than those in the exercise group,and the success rate of extubation was lower than that in the exercise group(P<0.05).The ALB and exercise rate of patients in the successful extubation group were higher than those in the failed extubation group,and the APACHEⅡscore was lower than that in the failed extubation group(P<0.05).Taking the failure of extubation as the dependent variable and the three indexes of APACHEⅡscore,ALB and exercise condition as the independent variables,multiple Logistic regression analysis was carried out.The results showed that high APACHEⅡscore(OR=1.276)and no exercise(OR=3.867)were the risk factors of extubation failure,with statistical significance(P<0.05).Conclusion The time of indwelling catheter,the rate of reintubation in 48 hours,the days of detention in ICU were lower,the success rate of extubation was higher,and there was no significant difference in catheter-related infection rate.