基于膀胱容量-压力测定指导间歇性导尿在老年神经源性膀胱康复中的应用研究

Application of intermittent catheterization guided by bladder volume pressure measurement in rehabilitation of elderly patients with neurogenic bladder

目的观察基于膀胱容量—压力测定指导间歇性导尿在老年神经源性膀胱康复中的效果,为治疗该病提供有效康复方案。方法选取空军军医大学第一附属医院西京医院2022年1月—2023年4月收治的老年神经源性膀胱患者82例,根据随机抽样法分为观察组和对照组,每组41例。患者入院即接受口服药物治疗,此外对照组患者予以临床常规护理,观察组在对照组处理基础上加用基于膀胱容量—压力测定指导间歇性导尿处理。记录并比较2组患者平均排尿次数、平均漏尿次数及最大排尿量;观察并比较2组患者干预前后残余尿量、膀胱容量、国际下尿路功能症状(LUTS)评分变化;评估并比较2组患者预后情况及护理满意度。结果观察组平均排尿次数及平均漏尿次数均低于对照组(P<0.05),而最大排尿量高于对照组(P<0.05)。干预前,2组残余尿量、膀胱容量及LUTS评分差异均无统计学意义(P>0.05);干预后,2组患者残余尿量及LUTS评分均低于同组干预前,2组患者膀胱容量均高于同组干预前,且观察组残余尿量及LUTS评分均低于对照组,而膀胱容量高于对照组,差异均有统计学意义(P<0.05)。随访3个月,2组复发率、泌尿系统感染发生率差异均无统计学意义(P>0.05),而观察组自主排尿率高于对照组(P<0.05)。观察组护理满意度高于对照组(P<0.05)。结论基于膀胱容量—压力测定指导间歇性导尿用于老年神经源性膀胱康复,可改善患者膀胱功能,临床效果较好,安全性及护理满意度较高,具有一定的应用前景。

Objective To observe the effects of intermittent catheterization guided by bladder volume pressure measurement in rehabilitation of elderly patients with neurogenic bladder,and provide an effective rehabilitation plan for the disease.Methods A total of 82 elderly patients with neurogenic bladder who were admitted to First Affiliated Hospital(Xijing Hospital)of Air Force Medical University from January 2022 to April 2023 were selected as the research subjects.They were randomly divided into control group and observation group according to random sampling method,with 41 patients in each group.All patients were treated with oral drugs after admission.The control group received routine clinical nursing,while the observation group received intermittent catheterization guided by bladder volume pressure measurement on the basis of control group.The average frequency of urination,the average frequency of urine leakage and the maximal volume of urination were recorded and compared between the two groups.The changes of residual urine volume,bladder volume and International Lower Urinary Tract Functional Symptoms(LUTS)score before and after intervention were observed and compared between the two groups.The prognosis and nursing satisfaction of the two groups were evaluated and compared.Results The average frequency of urination and average frequency of urinary leakage of the observation group were lower than those of the control group(P<0.05),and the maximal urination volume was greater than that of the control group(P<0.05).There was no significant difference in residual urine volume,bladder volume and LUTS score between the two groups before intervention(P>0.05).After intervention,the residual urine volume and LUTS score of both groups were lower than those of the same group before intervention,and the bladder volume of both groups was higher than that of the same group before intervention.Additionally,the residual urine volume and LUTS score of the observation group were lower than those of the control group,while the bladder volume was higher than that of the control group,with statistical significances(P<0.05).After 3 months of follow-up,there was no significant difference in the recurrence rate and incidence of urinary system infection between the two groups(P>0.05),but the autonomous urination rate in the observation group was higher than that in the control group(P<0.05).The nursing satisfaction of the observation group was higher than that of the control group(P<0.05).Conclusion Intermittent catheterization guided by bladder volumetric pressure measurement for the rehabilitation of elderly patients with neurogenic bladder can improve the bladder function of patients.Its clinical effect is good,and it has high safety and nursing satisfaction,and has a certain application prospect.