间歇导尿更换卧位对脊髓伤致神经源性膀胱患者泌尿系感染的影响

目的：探讨无菌间歇导尿（SterileIntermittentCatheterization，SIC）更换卧位对脊髓损伤（spinalcordinjury，SCI）致神经源性膀胱功能障碍（neurogenicbladder，NB），泌尿系感染（urinarytractinfection，UTI）并发症的影响。方法：SCI符合美国脊髓损伤学会（AmericanSpinalInjuryAssociation，ASIA）2011年标准；NB符合亚洲神经源性膀胱诊断治疗指南（2011版）的诊断标准。患者115例患者分为对照组56例，观察组59例，2组患者制定饮水计划并书写排尿日记，接受常用的膀胱功能训练，SIC，观察组导尿后采取更换卧位，分别叩击耻骨上、骶尾部和右侧／或左侧臀部，2次夹闭尿管、3次开放彻底i1流尿液。观察指标：血常规、尿常规、细菌培养、肾功能、B超等辅助检查，每次导尿时观察尿液的物理状态。结果：2组患者UTI的发生随间歇导尿呈减少趋势，但对照组经过3周的间歇导尿UTI发生并无减少。观察组与照组比较3周后有显著性差异（P〈0．01）。结论：SIC更换卧位引流尿液，能有效降低SCI致NB患者UTI的发生。

Intermittent catheterization to replace lie on spinal cord injury patients with neurogenic bladder Urinary tract infection

Objective：To discuss sterile Intermittent Catheterization replace the lying position of spinal cord injury, cause neurogenic bladder dysfunction urinary tract infection complications. Methods：SCL conforms to the American Spinal Injury Association 2011 standard; NB in Asian neurogenic bladder guide （2011） diagnostic criteria for the diagnosis and treatment. 56 cases patients, 115 patients were divided into control group, 59 cases of observation group, 2 groups of patients developed a plan of drinking water and voiding diary writing, commonly used bladder function training, SIC, Observation group after urethral catheterization to replace recumbent position, respectively the taps on the pubic bone, the tail and /or on the right side on the left side of the hips,, turn off 2 times, 3 times open drainage of urine, the urine drainage thoroughly. Ob- servation indexes： blood routine, urine routine, bacteria culture, kidney function, B ultrasonic auxiliary examination, each time observes the physical state of the urine catheter. Results ：Two groups the incidence of urinary tract infection in patients with intermittent catheterization showed a trend of decrease, but the control group after 3 weeks of intermittent catheterization and urinary tract infections occur no less. Observation： group compared with group according to the significant difference in 3 weeks （P 〈 0.01 ）. Conclusion： SIC replaced decubitus drainage of urine, could effectively reduce the urinary tract infection in patients with SCI to NB.