夹管训练结合膀胱功能康复训练对老年脑出血神经源性膀胱患者排尿功能及生活质量的影响

Effect of clamping tube training combined with bladder function rehabilitation training on urination function and quality of life of elderly patients with neurogenic bladder caused by cerebral hemorrhage

目的探讨夹管训练方式结合膀胱功能康复训练对由脑出血引起神经源性膀胱的老年患者的临床疗效。方法选择2019年1月-2020年6月海安市人民医院神经外科收治的脑出血所致神经源性膀胱的老年患者76例,按照随机数字表法将患者分为对照组和观察组,每组38例。对照组进行传统膀胱功能康复训练,观察组在对照组基础上加入夹管训练。分析比较2组患者临床疗效、排尿功能、国际下尿路症候群症状评分(lower urinary tract symptoms,LUTS)、生活质量量表(quality of life scale,QOL)评分以及改良Barthel指数(modified Barthel index,MBI)。结果治疗后,2组的症状均有所好转。观察组的临床有效率(94.74%)明显高于对照组(81.58%)(P<0.05);排尿功能情况比较,观察组的首次自主排尿时间(2.71±0.58)h少于对照组(4.27±0.92)h,首次排尿量多于对照组[(342.39±87.45)mL vs(269.38±68.22)mL](P<0.05);治疗后,2组的LUTS评分、QOL评分及MBI评分均有所好转,其中观察组的LUTS评分低于对照组[(13.53±2.69)分vs(18.37±3.22)分],而QOL评分和MBI评分高于对照组[(79.80±10.03)vs(74.16±9.80)],[(70.43±4.27)vs(52.24±3.09)](P<0.05)。结论夹管训练结合膀胱功能康复训练能够有效地改善由脑出血所致的神经源性膀胱老年患者的临床疗效,同时改善患者的排尿功能和下尿路症状,增强患者的日常生活活动能力,提高生活质量。

Objective To explore the clinical effect of clamping tube training combined with bladder function reha-bilitation training on elderly patients with neurogenic bladder caused by cerebral hemorrhage.Methods 76 elderly patients with neurogenic bladder caused by cerebral hemorrhage admitted to Department of Neurosurgery of Hai'an Hospital Affiliated to Nantong University from January 2019 to June 2020 were selected.According to the random number table method,they were divided into control group and observation group,with 38 ones in each group.The control group received traditional bladder function rehabilitation training,and the observation group added clamping tube training on the basis of the control gro-up.The clinical efficacy,urination function,International Lower Urinary Tract Syndrome Symptoms(LUTS)score,quality of life(QOL)scores and modified Barthel index(MBI)score of the two groups were analyzed and compared.Results After treatment,the symptoms of both groups were improved.The clinical effective rate of the observation group(94.74%)was significantly higher than that of the control group(81.58%)(P<0.05).In comparison of urination function,the first spontaneous urination time(2.71±0.58)h of the observation group was shorter than that of the control group(4.27±0.92)h and the first urination volume was more than that of the control group[(342.39±87.45)mL vs(269.38±68.22)mL](P<0.05).After treatment,the LUTS score,QOL score and MBI score of the two groups were improved.The LUTS score of the observation group was lower than that of the control group[(13.53±2.69)Vs(18.37±3.22)],while the QOL score and MBI score of the observation group were higher than those of the control group[(79.80±10.03)]VS[(74.16±9.80),(70.43±4.27)VS(52.24±3.09)](P<0.05).Conclusion Clamping tube training combined with bladder function rehabilitation training can effectively improve the clinical efficacy of elderly patients with neurogenic bladder caused by cerebral hemorrhage,improve their urination function and lower urinary tract symptoms,enhance their activities of daily living and improve their quality of life.