中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2013年
10期
1078-1080
,共3页
导尿%脊髓损伤%膀胱康复%影响
導尿%脊髓損傷%膀胱康複%影響
도뇨%척수손상%방광강복%영향
Catheterize%way%Spinal%cord%injury%Bladder%rehabilitation%Influence
目的 探讨不同导尿方式对脊髓损伤患者膀胱康复的影响及临床应用价值.方法 选择我院收治的108例脊髓损伤患者作为研究对象,按照采用导尿方式的不同分为间歇导尿组、留置导尿组及膀胱造瘘组,分别采用不同的导尿方式,观察3组患者排尿功能的恢复情况、并发症的发生情况及尿动力学指标.结果 采用不同的导尿方式后,间歇导尿组总有效率94.44％(34/36),留置导尿组总有效率72.22％(26/36),膀胱造瘘组总有效率58.33％(21/36),3组经统计学分析,差异有统计学意义(x2=36.556,P=0.000).间歇导尿组并发症发生率2.78％ (1/36),留置导尿组并发症发生率22.22％(8/36),膀胱造瘘组并发症发生率27.78％ (10/36),3组比较差异有统计学意义(x2=50.333,P＜0.05).间歇导尿组最大膀胱容量(258.97±32.15) ml,最大尿道压(54.18 ±8.74) cm H2O,最大闭合压(32.58 ±8.97) cm H2O,尿道功能长度(6.28±1.35) cm;留置导尿组:最大膀胱容量(178.18±49.35) ml,最大尿道压(36.11±10.12) cm H2O,最大闭合压(21.69±10.45) cm H2O,尿道功能长度(4.21±1.57) cm；膀胱造瘘组最大膀胱容量(154.88 ±42.84) ml,最大尿道压(33.45±11.07) cm H2O,最大闭合压(20.12 ±10.88) cm H2O,尿道功能长度(4.02±1.61) cm,3组比较差异均有统计学意义(F值分别为60.759、45.595、16.146、24.670;P均＜0.05).结论 间歇导尿方式在脊髓损伤患者泌尿系统管理中可以有效促进膀胱功能恢复,减少并发症发生,因此是患者值得考虑并选择的一种有效方法.
目的 探討不同導尿方式對脊髓損傷患者膀胱康複的影響及臨床應用價值.方法 選擇我院收治的108例脊髓損傷患者作為研究對象,按照採用導尿方式的不同分為間歇導尿組、留置導尿組及膀胱造瘺組,分彆採用不同的導尿方式,觀察3組患者排尿功能的恢複情況、併髮癥的髮生情況及尿動力學指標.結果 採用不同的導尿方式後,間歇導尿組總有效率94.44％(34/36),留置導尿組總有效率72.22％(26/36),膀胱造瘺組總有效率58.33％(21/36),3組經統計學分析,差異有統計學意義(x2=36.556,P=0.000).間歇導尿組併髮癥髮生率2.78％ (1/36),留置導尿組併髮癥髮生率22.22％(8/36),膀胱造瘺組併髮癥髮生率27.78％ (10/36),3組比較差異有統計學意義(x2=50.333,P＜0.05).間歇導尿組最大膀胱容量(258.97±32.15) ml,最大尿道壓(54.18 ±8.74) cm H2O,最大閉閤壓(32.58 ±8.97) cm H2O,尿道功能長度(6.28±1.35) cm;留置導尿組:最大膀胱容量(178.18±49.35) ml,最大尿道壓(36.11±10.12) cm H2O,最大閉閤壓(21.69±10.45) cm H2O,尿道功能長度(4.21±1.57) cm；膀胱造瘺組最大膀胱容量(154.88 ±42.84) ml,最大尿道壓(33.45±11.07) cm H2O,最大閉閤壓(20.12 ±10.88) cm H2O,尿道功能長度(4.02±1.61) cm,3組比較差異均有統計學意義(F值分彆為60.759、45.595、16.146、24.670;P均＜0.05).結論 間歇導尿方式在脊髓損傷患者泌尿繫統管理中可以有效促進膀胱功能恢複,減少併髮癥髮生,因此是患者值得攷慮併選擇的一種有效方法.
목적 탐토불동도뇨방식대척수손상환자방광강복적영향급림상응용개치.방법 선택아원수치적108례척수손상환자작위연구대상,안조채용도뇨방식적불동분위간헐도뇨조、류치도뇨조급방광조루조,분별채용불동적도뇨방식,관찰3조환자배뇨공능적회복정황、병발증적발생정황급뇨동역학지표.결과 채용불동적도뇨방식후,간헐도뇨조총유효솔94.44％(34/36),류치도뇨조총유효솔72.22％(26/36),방광조루조총유효솔58.33％(21/36),3조경통계학분석,차이유통계학의의(x2=36.556,P=0.000).간헐도뇨조병발증발생솔2.78％ (1/36),류치도뇨조병발증발생솔22.22％(8/36),방광조루조병발증발생솔27.78％ (10/36),3조비교차이유통계학의의(x2=50.333,P＜0.05).간헐도뇨조최대방광용량(258.97±32.15) ml,최대뇨도압(54.18 ±8.74) cm H2O,최대폐합압(32.58 ±8.97) cm H2O,뇨도공능장도(6.28±1.35) cm;류치도뇨조:최대방광용량(178.18±49.35) ml,최대뇨도압(36.11±10.12) cm H2O,최대폐합압(21.69±10.45) cm H2O,뇨도공능장도(4.21±1.57) cm；방광조루조최대방광용량(154.88 ±42.84) ml,최대뇨도압(33.45±11.07) cm H2O,최대폐합압(20.12 ±10.88) cm H2O,뇨도공능장도(4.02±1.61) cm,3조비교차이균유통계학의의(F치분별위60.759、45.595、16.146、24.670;P균＜0.05).결론 간헐도뇨방식재척수손상환자비뇨계통관리중가이유효촉진방광공능회복,감소병발증발생,인차시환자치득고필병선택적일충유효방법.
Objective To investigate the effects of different catheterize ways on the bladder rehabilitation of spinal cord injury patients and its clinical application.Methods One hundred and eight patients with spinal cord injury were divided into 3 groups according to the different catheterization ways:intermittent catheterization group,the indwelling catheterization group and bladder made fistula group.The micturition function recovery,complications and urine dynamics index of the three groups were recorded.Results The total effective rate were 94.44％ (34/36),72.22％ (26/36),58.33％ (21/36) respectively in intermittent catheterization group,indwelling catheterization group and bladder made fistula group,and the difference was statistically significant (x2 =36.556,P =0.000).Complication rates were 2.78％ (1/36),22.22％ (8/36) and 27.78％ (10/36) respectively in intermittent catheterization group indwelling catheterization group,bladder made fistula group,and the difference was statistically significant (x2 =50.333,P＜0.05).In intermittent catheterization group,the biggest bladder capacity was (258.97 ± 32.15) ml,maximum urethral pressure was (54.18 ± 8.74) cm H2O,he biggest closure pressure was (32.58 ± 8.97) cm H2O and urinary function length was(6.28 ± 1.35) cm.As for Indwelling catheterization group,biggest bladder capacity was(178.18 ± 49.35) ml,maximum urethral pressure was (36.11 ± 10.12) cm H2O,the biggest closure pressure was(21.69 ± 10.45) cm H2O and urinary function length was(4.21 ± 1.57) cm; In Bladder made fistula group,the biggest bladder capacity,maximum urethral pressure,the biggest closure pressure and urinary function length were (154.88 ± 42.84) ml,(33.45 ± 11.07) cm H20,(20.12 ± 10.88) cm H2O,(4.02 ± 1.61) cm,and the differences of regarding the all above indices were significant among three groups (F =60.759,45.595,16.146,24.670 respectively,P ＜ 0.05).Conclusion Intermittent catheterzation way was promoted the bladder function recovery,reduced complications effectively for patients with spinal cord injury.Therefore it was an effective method for patients in terms of the bladder rehabilitation.
