膀胱安全容量导尿法对骶上脊髓损伤患者下尿路功能的影响

doi:10.3969/j.issn.1006-9771.2021.06.010

《中国康复理论与实践》 ›› 2021, Vol. 27 ›› Issue (6): 692-697.doi: 10.3969/j.issn.1006-9771.2021.06.010

膀胱安全容量导尿法对骶上脊髓损伤患者下尿路功能的影响

张大伟¹,朱红军¹,冯晓燕¹,陈玉红¹,刘怡¹,陈康武²,蔡萍¹()

^1.苏州大学附属第一医院，康复科，江苏苏州市 215006
^2.苏州大学附属第一医院，骨外科，江苏苏州市 215006

收稿日期:2021-03-15 修回日期:2021-05-11 出版日期:2021-06-25 发布日期:2021-06-21
通讯作者: 蔡萍 E-mail:1723350416@qq.com
作者简介:张大伟(1987-)，男，汉族，安徽六安市人，博士研究生，主治医师，主要研究方向：神经康复。
基金资助:
国家自然科学基金青年基金项目(81802682)

Effect of Safety Bladder Capacity Catheterization on Lower Urinary Tract Function in Patients With Suprasacral Spinal Cord Injury

Da-wei ZHANG¹,Hong-jun ZHU¹,Xiao-yan FENG¹,Yu-hong CHEN¹,Yi LIU¹,Kang-wu CHEN²,Ping CAI¹()

^1.Department of Rehabilitation Medicine, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China
^2.Department of Orthopedics, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China

Received:2021-03-15 Revised:2021-05-11 Published:2021-06-25 Online:2021-06-21
Contact: Ping CAI E-mail:1723350416@qq.com
Supported by:
National Natural Science Foundation of China (Youth)(81802682)

摘要/Abstract

摘要： 目的

评估依据膀胱安全容量行间歇性导尿对骶上脊髓损伤患者下尿路功能的影响。

方法

2019年1月至12月选取本院骶上脊髓损伤后下尿路功能障碍患者60例，随机分为对照组(n = 30)和观察组(n = 30)。对照组行间歇性导尿，导尿频率依据残余尿。观察组行间歇性导尿，导尿频率依据膀胱安全容量。比较两组最大逼尿肌压、残余尿、膀胱安全容量、尿路感染情况和逼尿肌厚度。

结果

治疗8周后，观察组最大逼尿肌压、残余尿减少，膀胱安全容量显著增加(t > 5.623, P < 0.05)，且均优于对照组(t > 2.242, P < 0.05)；逼尿肌厚度显著降低(t = 7.871, P < 0.05)，且明显低于对照组(t = 3.049, P < 0.01)，尿路感染次数少于对照组(χ² = 4.320, P = 0.038)。

结论

依据膀胱安全容量行间歇性导尿，可以改善骶上脊髓损伤患者下尿路功能。

关键词: 脊髓损伤, 间歇性导尿, 膀胱安全容量

Abstract: Objective

To evaluate the effect of safety bladder capacity catheterization on lower urinary tract function in patients with supracacral spinal cord injury.

Methods

A total of 60 patients with lower urinary tract dysfunction after suprasacral spinal cord injury in our hospital from January to December, 2019 were divided into control group (n = 30) and observation group (n = 30) randomly. Both groups were given intermittent catheterization, the frequency of catheterization was determined according to postvoid residual volume in the control group, while it was according to safety bladder capacity in the observation group. Their maximum destrusor pressure, postvoid residual volume, safety bladder capacity, urinary tract infection and detrusor wall thickness were compared.

Results

Eight weeks after intervention, the maximum destrusor pressure and postvoid residual volume decreased, and the safety bladder capacity increased in the observation group (t > 5.623, P < 0.05), and were better than that of the control group (t > 2.242, P < 0.05); the detrusor wall thickness significantly decreased in the observation group (t = 7.871, P < 0.05), and was lower than that of the control group (t = 3.049, P < 0.01). The number of urinary tract infection patients was less in the observation group than in the control group (χ² = 4.320, P = 0.038).

Conclusion

Intermittent catheterization based on safety bladder capacity can improve lower urinary tract function in patients with suprasacral spinal cord injury.

Key words: spinal cord injury, intermittent catheterization, safety bladder capacity

中图分类号:

R651.2

张大伟,朱红军,冯晓燕,陈玉红,刘怡,陈康武,蔡萍. 膀胱安全容量导尿法对骶上脊髓损伤患者下尿路功能的影响[J]. 《中国康复理论与实践》, 2021, 27(6): 692-697.

Da-wei ZHANG,Hong-jun ZHU,Xiao-yan FENG,Yu-hong CHEN,Yi LIU,Kang-wu CHEN,Ping CAI. Effect of Safety Bladder Capacity Catheterization on Lower Urinary Tract Function in Patients With Suprasacral Spinal Cord Injury[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(6): 692-697.

图/表 3

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组别	n	性别(n)		年龄(岁)	病程(月)	损伤程度(n)
组别	n	男	女	年龄(岁)	病程(月)	完全性损伤	不完全性损伤
对照组	30	28	2	47.47±12.13	4.00±1.23	7	23
观察组	30	26	4	49.10±13.23	4.23±1.57	9	21
χ²/t值		0.185		0.498	0.641	0.341
P值		0.667		0.620	0.524	0.559

组别	n	最大逼尿肌压(cmH₂O)		残余尿(ml)		膀胱安全容量(ml)
组别	n	干预前	干预8周后	干预前	干预8周后	干预前	干预8周后
对照组	30	71.40±19.30	69.67±17.65	239.43±80.30	221.56±79.50	326.43±65.01	352.53±58.61
观察组	30	73.70±16.89	60.53±13.66^a	233.67±70.04	174.00±65.18^b	330.53±65.20	388.77±59.17^c
t值		0.491	2.242	0.296	2.534	0.244	2.383
P值		0.625	0.029	0.768	0.014	0.808	0.020

组别	n	干预前	干预8周后
对照组	30	1.14±0.20	1.08±0.18
观察组	30	1.16±0.21	0.96±0.13^a
t值		0.328	3.049
P值		0.744	0.003

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膀胱安全容量导尿法对骶上脊髓损伤患者下尿路功能的影响

Effect of Safety Bladder Capacity Catheterization on Lower Urinary Tract Function in Patients With Suprasacral Spinal Cord Injury

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