脊髓损伤患者间歇导尿过程中自主神经反射障碍的影响因素

doi:10.3969/j.issn.1006-9771.2021.02.005

Abstract

Abstract: Objective

To investigate the occurrence and related factors of autonomic dysreflexia (AD) during intermittent catheterization in patients with spinal cord injury (SCI).

Methods

Case control study was used in this study. Intermittent catheterization was performed on 44 SCI patients hospitalized from April, 2019 to April, 2020, The data of age, gender, time after injury, segment of injury, degree of injury, resting blood pressure, immediate blood pressure after catheterization, catheterization numbers, catheterization volume and duration of catheterization were collected. Descriptive analysis and binary Logistic regression analysis were used to analyze the occurrence and related factors of AD.

Results

Totally, AD happened in 26 (59.1%) patients. Urethral catheterization was done 1738 times, out of which AD accounted for 187 times (10.8%). The risk of AD increased with the time after injury and age (P < 0.05). The probability of AD was lower in T₇ SCI and below than in T₆ SCI and above (P = 0.002). Catheterization numbers, gender, degree of injury, catheterization volume and duration of catheterization were not influencing factors of AD (P > 0.05).

Conclusion

It is necessary to have a full understanding for the occurrence of AD in patients with SCI during intermittent catheterization. For patients with SCI in T₆ and above, long time after injury and elderly patients, routine monitoring of blood pressure during intermittent catheterization is recommended to detect and deal with AD in time.

Key words: spinal cord injury, autonomic dysreflexia, intermittent urinary catheterization, related factors

CLC Number:

R651.2

Bo WEI,Gen- lin LIU,Wei SUN,Lin-yi WANG,Ying ZHENG,Chun-xia HAO,Ying ZHANG,Yi-ji WANG,Hai-qiong KANG,Xiao-lei LU,Yuan YUAN,Qian-ru MENG,Hong-jun ZHOU. Factors Related to Autonomic Dysreflexia during Intermittent Catheterization in Patients with Spinal Cord Injury[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(2): 150-155.

Figures/Tables 4

References 40

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项目		对照组(n =18)	病例组(n = 26)
性别	男	13	22
	女	5	4
年龄	30岁以下	4	5
	30~50岁	7	11
	50岁以上	7	10
损伤节段	T₆及以上	14	19
	T₇及以下	4	7
损伤程度	完全性脊髓损伤	5	12
	不完全性脊髓损伤	13	14

变量	B	S.E.	Wald	df	P	Exp(B)	Exp(B)的95%置信区间
导尿次数	0.000	0.000	0.052	1	0.820	1.000	1.000~1.000
伤后时间(个月)	0.021	0.005	21.677	1	< 0.001	1.022	1.012~1.031
年龄	0.029	0.008	14.398	1	< 0.001	1.030	1.014~1.046
性别	-0.200	0.242	0.686	1	0.408	0.819	0.510~1.315
损伤节段	-1.051	0.336	9.818	1	0.002	0.349	0.181~0.675
损伤程度	-0.191	0.204	0.879	1	0.349	0.826	0.554~1.232
导尿量(ml)	0.001	0.001	0.348	1	0.555	1.001	0.999~1.002
导尿操作持续时间(min)	0.047	0.074	0.403	1	0.525	1.048	0.907~1.210
常量	-4.207	0.898	21.935	1	< 0.001	0.015

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Factors Related to Autonomic Dysreflexia during Intermittent Catheterization in Patients with Spinal Cord Injury

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