间歇性导尿全程管理模式在神经源性膀胱患者中的应用效果研究

Effect of the whole-course manangement of intermittent catheterization in neurogenic bladder patients

目的探讨间歇性导尿全程管理模式在神经源性膀胱患者中的应用效果。方法选择2019年5月—10月在四川大学华西医院康复医学中心住院的不完全性脊髓损伤所致的神经源性膀胱患者。按随机数字表将患者随机分为试验组和对照组。对照组采用间歇性导尿传统管理模式,试验组采用间歇性导尿全程管理模式。比较两组患者排尿日记(单次导尿量、残余尿量、漏尿次数)、尿常规中的细菌和白细胞数量。结果最终纳入患者80例,每组各40例。两组患者在入院时的排尿日记、尿常规及管理第2周的排尿日记各项指标上比较,差异均无统计学意义(P>0.05)。管理第12周,两组排尿日记各项指标比较,差异均有统计学意义(P<0.05)。试验组管理第2周和第12周的白细胞计数、细菌计数均低于对照组(P<0.05)。结论对不完全性脊髓损伤所致神经源性膀胱患者实施间歇性导尿全程标准化管理,能够改善膀胱容量,减少残余尿量及漏尿次数、降低泌尿系统感染发生率,减少泌尿系统并发症,提高患者生存质量。

Objective To discuss the effect of the whole-course management model of intermittent catheterization(IC) in patients with neurogenic bladder(NB). Methods Patients with NB caused by incomplete spinal cord injury admitted to Department of Rehabilitation Medicine of West China Hospital of Sichuan University between May and October 2019 were selected. According to the random number table, the patients were randomly divided into the trial group and the control group. The control group adopted the traditional management mode of IC, and the trial group adopted the whole-course management mode of IC. The urination diary(single catheterization volume, residual urine volume, and times of urine leakage), bacteria count and leukocyte count in urine routine were compared between the two groups. Results Finally 80 patients were included, with 40 cases in each group. There was no significant difference in urination diary, bacteria count or leukocyte count in urine routine between the two groups(P>0.05). There was no significant difference between the two groups in urination diary in the second week of management(P>0.05). At the 12 th week of management, there were statistically significant differences in urination diary between the two groups(P<0.05).The bacteria count and leukocyte count in the second and 12 th week of the management in the trial group were lower than those in the control group(P<0.05). Conclusions The whole-course management of IC for patients with NB caused by incomplete spinal cord injury can effectively improve bladder volume, and reduce residual urine volume and times of urine leakage. It also can reduce the incidence of urinary tract infection, reduce urinary complications, and ultimately improve the quality of life of patients.