以问题为导向的康复护理在脊髓损伤神经源性膀胱患者中的应用效果

Application effects of problem-oriented rehabilitation nursing in patients with neurogenic bladder after spinal cord injuries

目的:观察基于问题为导向的康复护理在脊髓损伤神经源性膀胱患者中的应用效果。方法:选取2019年2月至2021年2月该院收治的60例脊髓损伤神经源性膀胱患者进行前瞻性研究,按照随机数字表法分为对照组和观察组各30例。对照组予以常规护理,观察组予以基于问题为导向的康复护理,比较两组护理前后膀胱功能(残余尿量、最大尿流速、膀胱容量)、生命质量[健康调查简表(SF-36)]评分、排尿指标(每日漏尿次数、排尿次数及每次排尿量)水平和护理2、4、6、8周后尿路感染发生率。结果:护理后,观察组残余尿量、每日漏尿次数、每日排尿次数均少于对照组,最大尿流速、膀胱容量均高于对照组,每次排尿量多于对照组,差异有统计学意义(P<0.05);护理后,观察组情感职能、社会功能、生理机能、一般健康状况、生理职能、躯体疼痛、精力和精神健康等SF-36评分均高于对照组,差异有统计学意义(P<0.05);观察组护理2、4、6、8周后的尿路感染发生率均低于对照组,差异有统计学意义(P<0.05)。结论:基于问题为导向的康复护理应用于脊髓损伤神经源性膀胱患者可提高膀胱功能和生命质量评分,改善排尿指标水平,降低尿路感染发生率,效果优于常规护理。

Objective:To observe application effects of problem-oriented rehabilitation nursing in patients with neurogenic bladder after spinal cord injuries.Methods:A prospective study was conducted on 60 patients with neurogenic bladder after spinal cord injuries admitted to the hospital from February 2019 to February 2021.They were divided into control group and observation group according to the random number table method,30 cases in each group.The control group was given routine nursing,while the observation group received the problem-based rehabilitation nursing.The bladder function(residual urine volume,maximum urine flow rate,bladder capacity),the quality of life[short form health survey(SF-36)]score,the urination index levels(daily leakage times,urination times and each urination volume)before and after the nursing,and the incidence of urinary tract infection 2,4,6 and 8 weeks after the nursing were compared between the two groups.Results:After the nursing,the residual urine volume,the daily leakage times and the daily urination times in the observation group were less than those in the control group;the maximum urine flow rate and the bladder capacity were higher than those of the control group;the urine volume per time was more than that of the control group;and the differences were statistically significant(P<0.05).After the nursing,the SF-36 scores of emotional function,social function,physiological function,general health status,physiological role,physical pain,vitality and mental health in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Further,the incidences of urinary tract infection 2,4,6 and 8 weeks after the nursing in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusions:The problembased rehabilitation nursing applied to the patients with neurogenic bladder after spinal cord injuries can improve the bladder function and the quality of life score and improve the level of urination indexes and the incidence of urinary tract infection.Moreover,it is superior to the routine nursing.