间歇性导尿技术在脑卒中合并神经源性膀胱患者中的应用研究

Application of intermittent catheterization in stroke patients with neurogenic bladder

目的探讨间歇性导尿技术在脑卒中合并神经源性膀胱(post-stroke neurogenic bladder,PSNB)患者中的应用效果。方法选取2020年1月—2020年12月赣南医学院第一附属医院确诊的100例脑卒中合并神经源性膀胱(PSNB)患者,随机分为观察组45例和对照组55例,2组患者均接受膀胱功能训练,对照组患者采用常规留置导尿技术(urinary catheter insertion,UCI)进行治疗,观察组采用间歇性导尿技术(clean intermittent self-catheterization,CISC)进行治疗,2组均治疗8周。比较2组患者治疗前后的尿动力学指标[最大膀胱容量(maximum cystometric capacity,MBC)、最大尿流速率(the maximum flow rate,Qmax)、残余尿量(residual urine volume,RUV)]、膀胱平衡功能良好率和治疗期间并发症发生情况。结果治疗前,2组RUV、MBC、Qmax比较差异无统计学意义(P>0.05);观察组治疗后RUV低于对照组,MBC、Qmax高于对照组(P<0.05);治疗后观察组的平衡膀胱良好率51.11%,高于对照组的9.09%(P<0.05);观察组尿路感染、尿潴留、尿液反流发生率均低于对照组(P<0.05)。结论CISC技术在治疗PSNB患者时可有效恢复膀胱功能,保障膀胱平衡,避免尿路感染、尿潴留等并发症发生,具有较高的安全性。

Objective To investigate the application of intermittent catheterization in stroke patients with neurogenic bladder(PSNB).Methods The clinical data of 100 stroke patients with neurogenic bladder(PSNB)diagnosed in the First Affiliated Hospital of Gannan Medical College from January 2020 to December 2020 were selected and divided into observation group(45 cases)and control group(55 cases)according to the different catheterization methods.Both groups received bladder function training.The control group was treated with conventional indwelling catheterization(UCI).The observation group was treated with intermittent catheterization(CISC),and both groups were treated for 8 weeks.The urodynamic indexes[maximum bladder volume(MBC),maximum urinary flow rate(Qmax),residual urine volume(RUV)],the incidence of bladder balance function and the incidence of complications during treatment were compared between the two groups.Results Before treatment,there was no significant difference in RUV,MBC,and Qmax between the two groups(P>0.05).After treatment,the RUV of the observation group was lower than that of the control group,while MBC and Qmax were higher than that of the control group(P<0.05).After treatment,the balanced bladder rate in the observation group was 51.11%higher than that in the control group,which was 9.09%(P<0.05).The incidence of urinary tract infection,urinary retention and urinary reflux in the observation group were lower than those in the control group(P<0.05).Conclusion CISC technology in the treatment of patients with psnb can effectively promote the recovery of bladder function,maintain bladder balance,reduce the risk of complications such as urinary tract infection and urinary retention,and has high safety.