家庭支持模式对脑卒中后神经源性膀胱患者膀胱功能的影响

Effect of family support model on bladder function in patients with neurogenic bladder after stroke

目的探讨家庭支持模式对脑卒中后神经源性膀胱患者膀胱功能的影响。方法选取2018年2月至2020年2月在苏州市市立医院北区治疗的脑卒中后神经源性膀胱患者70例,随机分为研究组和对照组。对照组由护理人员指导照顾者在院外进行家庭康复锻炼,包括疾病知识宣教、康复训练培训、心理疏导、家庭康复环境改造等,并进行追踪调查及康复指导。出院前及出院后家庭支持干预6w后分别进行评测,使用排尿日记的频率-尿量图表记录患者日排尿频次及单次排尿量;使用WHOQOL-BREF量表进行生活质量评价。结果①治疗后,两组患者的尿失禁指标均获得明显改善;研究组患者的日间排尿频次明显低于对照组、而单次最大尿量明显优于对照组,差异均有统计学意义(均P<0.05)。②治疗后,两组患者的疼痛评分均明显改善;研究组患者的疼痛评分明显低于对照组,差异均有统计学意义(均P<0.05)。③治疗后,两组患者的生活质量评分均明显改善;研究组患者的生理领域、心理领域、社会关系领域、环境领域等各项评分及总生活质量评分明显优于对照组,差异均有统计学意义(均P<0.05)。结论家庭支持模式能减轻脑卒中后神经源性膀胱患者的泌尿系排尿功能障碍,减少日间排尿频次,增大单次最大排尿量,改善患者的生活质量。

Objective To investigate the effect of family support model on bladder function in patients with neurogenic bladder after stroke.Methods A total of 70 patients with post-stroke neurogenic bladder treated in this hospital from February 2018 to February 2020 were randomly divided into study group and control group.In the control group,the caregivers were instructed by the nursing staff to conduct family rehabilitation exercises outside the hospital,including disease knowledge education,rehabilitation training,psychological counseling,family rehabilitation environment modification.At the same time,they were followed up and given rehabilitation guidance.Before discharge and 6 weeks after the intervention of family support after discharge,the frequency of urination diary and urine volume chart were used to record the daily urination frequency and single urination volume of patients.Quality of life was evaluated using the World Health Organization Quality of Life Questionaire abbreviated version(WHOQOL-BREF).Results①After treatment,urinary incontinence indexes in both groups were significantly improved.The daily urination frequency of the study group was significantly lower than that of the control group,while the maximum single urine volume was significantly better than that of the control group,the differences were statistically significant(P<0.05).(2)After treatment,the pain scores of patients in both groups were significantly improved.The pain scores in the study group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).③After treatment,the quality of life scores of patients in both groups were significantly improved.The scores of physiological field,psychological field,social relationship field,environmental field and total quality of life in the study group were significantly better than those in the control group,and the differences were statistically significant(P<0.05).Conclusions Family support model can reduce urinary dysfunction in patients with neurogenic bladder after stroke,reduce daytime urination frequency,increase the maximum single urination volume,and improve the quality of life of patients.