脊髓损伤致截瘫患者导尿方式的选择及其影响因素

目的调查脊髓损伤导致截瘫患者导尿方式的选择及其影响因素。方法方便性抽样选取2011年1-8月上海市部分医疗机构脊髓损伤致截瘫患者91例,采用自制调查表对其进行问卷调查。结果本组91例患者中,选择留置导尿者61例占67.03%,选择间歇导尿者30例占32.97%。患者性别、年龄、文化层次、月收入、截瘫部位等对截瘫患者选择导尿方式的影响无差异(均P>0.05);截瘫时间以及泌尿系并发症出现频率对截瘫患者选择导尿方式有影响,差异均具有统计学意义(均P<0.05);93.44%的截瘫患者接受专业的泌尿系管理知识培训。结论间歇导尿(clean intermittent catheterization,CIC)是保护脊髓损伤后膀胱功能障碍的比较安全有效的方法,可明显降低尿路感染的发生率,提高排尿功能障碍患者的生存质量。截瘫时间较长和频繁发生泌尿系感染是截瘫患者更容易接受清洁间歇导尿方法的主要影响因素。提示医护人员有责任和义务为患者提供专业化的培训,帮助指导截瘫患者正确使用间歇清洁导尿,减少泌尿系问题出现的频率,提高生存质量。

Current Status and Strategies on Selection of Catheterization Method in Patients with Spinal Cord Injury

Objective To investigate the selection and its influencing factors of catheterization method in paraplegic patients caused by spinal cord injury（SCI）. Methods From January to August 2011,91 paraple- gic patients following SCI were selected by convenience sampling method using a self-designed urinary tract management cognitive questionnaire. Results Ninety-one valid questionnaires were collected. Gender, age, educational level,monthly income,or paraplegia site had no significant difference in the selection of cathe- terization methods（P〉0.05）. While paraplegia time and frequency of urinary tract problems affected the catheterization ways chosed by paraplegic patients（P〈0.05）. Totally 93.44% cases claimed that no sys- tematic and professional management of urinary tract training was received. Conclusion Clean intermittent catheterization（CIC） can effectively and safetly improve the bladder dysfunction of SCI patients. Compared with retention catheterization,CIC can significantly reduce the incidence of urinary tract infection, and im- prove the quality of life. Those patients with long paraplegia time and frequent urinary tract infections are more likely to accept CIC. Therefore, medical staff have the responsibility and obligation to provide para- plegic patients with specialized training of the proper use of intermittent catheterization, so as to reduce the urinary tract problems and improve the quality of life.