间歇性导尿在脑卒中合并神经源性膀胱患者膀胱功能恢复及降低尿路感染中的应用

目的 探讨间歇性导尿对脑卒中合并神经源性膀胱患者膀胱功能恢复及降低尿路感染的作用.方法 选择脑卒中合并尿潴留患者79例按随机数字表法分为对照组(36例)和观察组(43例).两组患者均进行常规康复治疗.对照组予以保留导尿;观察组行间歇性导尿.治疗8周后比较两组患者临床效果、治疗前后膀胱容量和残余尿量、尿路感染率及生活质量(QOL).结果 8周后与治疗前相比,观察组患者尿潴留发生率得到明显改善,膀胱容量显著增加(P＜0.01);残余尿量显著减少,尿路感染率显著下降,QOL得到明显提高(P＜0.001).观察组以上各项与对照组8周后相应指标比较均差异有统计学意义(P＜0.05).结论 间歇性导尿对降低脑卒中合并神经源性膀胱患者尿路感染发生率,重建自主排尿功能具有积极的意义.

Application of intermittent catheterization to recovery of cystic function and decrease in the incidence of urinary infection for patients with cerebral apoplexy and concomitant neurogenic bladder

Objective To explore the positive effect of intermittent catheterization on the recovery of bladder function and reduction of urinary tract infection in patients diagnosed as cerebral apoplexy concomitant with neurogenic bladder.Methods Totally 79 patients were diagnosed as cerebral apoplexy concomitant with neurogenic bladder and were prospectively randomized into two groups:control group(36 patients) and research group (43 patients).Patients in the control group were given continuous catheterization while those in the research group were given intermittent catheterization.The clinical curative rate,cystometric capacity,postvoiding residual urine,occurrence rate of UTI (urinary tract infection),and QOL (quality of life) were compared after 8 weeks of treatment between two groups.Results In the research group,incidence rate of urinary retention declined obviously and bladder capacity increased significantly (P<0.01),meanwhile,residual urine volume was reduced,QOL was improved,and UTI rate declined obviously (P<0.001) compared with control group after 8 weeks of treatment.The above differences between two groups had all statistical significance (P<0.05).Conclusions Intermittent catheterization can not only reduce the incidence rate of UTI but also have a positive effect on restoring the bladder function and recovering peeing autonomously upon those stroke patients concomitant with neurogenic bladder.