整体化康复干预对创伤性脊髓损伤的应用效果及对患者神经源性膀胱功能的影响

Effect of holistic rehabilitation intervention on the function recovery of neurogenic bladder in patients with traumatic spinal cord injury

目的分析整体化康复干预对创伤性脊髓损伤的应用效果及对患者神经源性膀胱功能恢复情况的影响。方法选择2021年3月至2023年3月神经外科脊髓脊柱病房收治的94例创伤性脊髓损伤患者,根据电脑随机数字表法分组,对照组47例予以常规护理,观察组47例予以整体化康复干预,比较2组患者的排尿症状、尿动力学、神经源性膀胱功能恢复情况及生活质量。结果观察组患者的日均漏尿次数与排尿次数均低于对照组(P<0.05),24 h单次排尿量高于对照组(P<0.05);观察组患者的膀胱压与逼尿肌压均低于对照组(P<0.05),而膀胱容量及膀胱顺应性高于对照组(P<0.05);观察组患者的神经源性膀胱症状评分表分数低于对照组,差异有统计学意义(P<0.05);观察组患者的神经源性膀胱生命质量量表评分低于对照组(P<0.05)。结论整体化康复干预在创伤性脊髓损伤中的应用可取得显著效果,不仅能改善患者的排尿症状与尿动力学,而且还能促进其神经源性膀胱功能恢复,进一步提高患者生活质量。

Objective To analyze the application effect of holistic rehabilitation intervention on the function recovery of neurogenic bladder in patients with traumatic spinal cord injury.Methods Ninety-four patients with traumatic spinal cord injury admitted to spinal cord ward,Neurosurgery Department,Beijing Tiantan Hospital from March 2021 to March 2023 were selected as subjects,and they were randomly assigned to routine care(control group,n=47)or integrated rehabilitation intervention(observation group,n=47).The urination symptoms,urodynamics,function recovery of neurogenic bladder and quality of life were compared between groups.Results the average times of the 24-hour urine leakage and urination in the observation group were significantly lower than those in the control group,while the 24h single urination volume was significantly higher(P<0.05).The bladder pressure and detrusor pressure in the observation group were significantly lower than those of the control group(P<0.05),while the bladder capacity and bladder compliance were significantly higher(P<0.05).The score of neurogenic bladder symptoms in the observation group was significantly lower than that in the control group(P<0.05).The quality of life scale scores were significantly better in the observation group than in the control group(P<0.05).Conclusion The application of holistic rehabilitation intervention in traumatic spinal cord injury can achieve remarkable results,not only improve the urination symptoms and urodynamics,but also promote the function recovery of neurogenic bladder and further improve the quality of life of patients.