脑卒中与排尿障碍的研究进展

排尿障碍是脑卒中患者的常见症状,严重影响患者的生活质量,分析排尿障碍与脑卒中的关系对指导脑卒中治疗具有重要意义。本文通过查阅大量国内外文献,综合论述近年有关脑卒中与排尿障碍的研究及其进展。     

Orem自理理论在脑卒中继发排尿障碍患者中的护理应用

目的 探讨Orem自理理论在脑卒中继发排尿障碍患者中的应用效果。方法将46例患者随机分为观察组和对照组．两组均予以中医科常规护理，观察组在常规治疗的基础上加用Orem自理理论分级护理，观察两组患者的预后。结果观察组的排尿障碍恢复情况好于对照组（P〈0．05）。结论Orem自理理论结合常规护理可使脑卒中继发排尿障碍患者有效恢复排尿功能，有利于患者康复，降低致残率。     

Orem自理理论在脑卒中继发排尿障碍患者中的护理应用

目的探讨Orem自理理论在脑卒中继发排尿障碍患者中的应用效果。方法将46例患者随机分为观察组和对照组,两组均予以中医科常规护理,观察组在常规治疗的基础上加用Orem自理理论分级护理,观察两组患者的预后。结果观察组的排尿障碍恢复情况好于对照组(P<0.05)。结论Orem自理理论结合常规护理可使脑卒中继发排尿障碍患者有效恢复排尿功能,有利于患者康复,降低致残率。     

Orem自理理论在脑卒中后排尿障碍患者护理中的应用价值

目的探讨Orem自理理论在脑卒中后排尿障碍患者中的应用价值。方法将60例脑卒中后伴随排尿障碍患者随机分为干预组和对照组各30例,两组均给予神经科常规护理及治疗,干预组在此基础上加用Orem自理理论进行护理干预,评估患者的日常生活活动能力变化及排尿障碍改善状况。结果干预组患者干预后的Barthel指数评分明显高于对照组,差异有统计学意义(P<0.05)。干预组排尿障碍改善的总有效率为80.0%,显著高于对照组的50.0%,差异有统计学意义(P<0.05)。结论 Orem自理理论应用于脑卒中后排尿障碍患者能明显改善患者的排尿障碍,并提高患者的整体日常生活活动能力。     

卒中排尿障碍的心理护理

卒中患者排尿障碍发生率高[1] ,排尿控制能力受损 ,常合并急躁、易怒、失眠、不安、悲观等心理反应 ,严重影响患者的全面康复。临床上主要通过膀胱训练、导尿、物理疗法、肢体功能锻炼等方法 ,作者对卒中排尿障碍患者同时行心理护理 ,现报告如下。1　资料和方法1·1　临床资料　住院卒中排尿障碍患者 4 37例 ,其中男 2 71例 ,女 166例 ,年龄 2 0～ 96岁 ,平均年龄 63 3岁。脑出血 183例 ,脑梗塞 2 19例 ,蛛网膜下腔出血 2 0例 ,脑栓塞 7例 ,脑血栓形成 8例。将全部患者随机分成两组。心理护理组 2 13例 ,男 132例 ,女 81例 ,最小年龄 2 1岁 …     

排尿和排便障碍的护理

脑血管疾病的患者,大小便多数不能自理,容易出现排尿和排便的障碍,主要包括便秘、便失禁、尿潴留、尿失禁。现将护理体会总结如下。 1 一般护理 1.1 便秘由于患者卧床时间长胃肠蠕动减慢,加上排便     

谨防糖尿病性排尿障碍

很多人患糖尿病后,早期无明显的“三多一少”症状。这意味着他们得了隐性糖尿病,却被忽视了,后来因为其他症状就诊时才被发现。糖尿病性排尿障碍就是其中之一。下面有两个真实的事例:例1．半年前,方奶奶无意中发现小腹部有一肿块,不痛不痒,也就没     

引起排尿障碍的药物种种

前列腺疾病最痛苦的症状莫过于排尿障碍，一方面可能与炎症有关，另一方面由于前列腺狭窄限制了尿路通畅。除疾病本身可引起排尿障碍外，有许多药物也可能引起排尿障碍，因此，患前列腺疾病的人群，在使用某些药物时要特别注意，以防排尿障碍加重。目前所知。可引起排尿障碍的药物主要有以下几方面。     

脑卒中后睡眠障碍的研究进展

脑卒中后睡眠障碍是严重且常见的脑卒中并发症之一,严重的睡眠障碍不仅影响患者的日常生活质量、心理健康及神经功能康复,而且还会增加脑卒中复发的危险性。睡眠障碍的表现形式多样,目前对睡眠障碍发生机制的探讨已经深入到分子生物学、神经内分泌学等各个方面,而对于治疗的研究也不再局限于使用镇静催眠类药物,更趋于综合疗法。     

老年男性排尿障碍患者尿流动力学检查的护理配合

目的探讨在老年男性排尿障碍患者尿流动力学检查过程中护理配合及心理护理对检查的作用。方法总结241例老年男性排尿障碍患者尿流动力学检查前、中、后的护理措施。结果 241例患者配合满意,心理状态良好,顺利完成尿流动力学检查。结论密切的护理配合及积极的心理护理可提高老年男性排尿障碍患者尿流动力学检查结果的准确性。     

成年女性压力性尿失禁危险因素探讨

目的调查长沙市女性压力性尿失禁的患病率及相关发病因素。方法随机抽取2004年10月~2005年5月因非尿失禁因素就诊于我院妇科门诊年满18岁的妇女进行问卷调查。结果发放问卷5 000份,回收5 000份,回收率100%。结果显示,压力性尿失禁患病率35.83%,与年龄成正相关。结论压力性尿失禁是妇女的常见病,随年龄增加患病率增加,且妊娠及分娩次数多、阴道难产、会阴裂伤、急产、产后过早劳动、末次分娩年龄≥30岁、吸烟饮酒及合并有心血管疾病、支气管炎、糖尿病、尿路感染、生殖器肿瘤、子宫脱垂等都是发病的相关因素。而激素替代治疗可以减少发病。     

干扰电疗法治疗脑卒中尿失禁的临床疗效观察

目的:观察干扰电疗法治疗脑卒中后尿失禁的疗效。方法:将44例脑卒中患者随机分成治疗组和对照组各22例,治疗组采用干扰电疗法加常规治疗;对照组只采用常规治疗。结果:经过4周的治疗后,治疗组22例有效,有效率100%。对照组12例有效,有效率54.54%。比较有显著性差异(P≤0.05)。结论:干扰电疗法改善脑卒中患者的控尿功能,对治疗脑卒中后尿失禁安全有效。     

Dyspareunia, Urinary Sensory Symptoms, and Incontinence Among Young Chinese Women

This study examined the prevalence of dyspareunia, urinary sensory symptoms, and urinary incontinence and explored their associations among sexually active Chinese women aged 15–34 years. Data from 3,150 women were analyzed from a survey undertaken during 2003 in 30 counties in China as part of the United Nations Population Fund Country Program. The overall prevalence of dyspareunia was 4.7%. Urinary pain, burning or frequency was reported by 8.5%, 6.2% reported urinary incontinence, and 2.3% reported both sets of urinary symptoms. The prevalence of urinary incontinence, both alone and in combination with sensory symptoms, increased in a linear manner with age. Dyspareunia was associated with early sexual debut, primary level of education, and membership of minority ethnic communities. Urinary sensory symptoms and incontinence were more common among those reporting early sexual debut, those with less schooling, and women engaged in agricultural and manual unskilled occupations. Urinary incontinence was more common among women who had had a previous vaginal delivery compared to nulliparous women. Dyspareunia was strongly associated with the presence of urinary symptoms, particularly among those with both sensory symptoms and incontinence (26.8%). Nearly a quarter of women who had dyspareunia had sought treatment but fewer had done so for urinary incontinence. Dyspareunia and urinary symptoms show distinct but overlapping patterns of association with demographic variables. The findings indicate unmet need for assessment and advice about these symptoms in women’s reproductive health programs.     

女性尿失禁患者生活质量调查

目的:探讨妇科门诊患者尿失禁的严重程度及其对生活质量的影响。方法:对2003年11月~2004年12月就诊于广州市妇婴医院妇科门诊年龄为18~86岁的1 880例女性患者以调查表进行面对面问卷调查。调查内容有一般状况(包括年龄、身高、体重、婚姻状况、收入、文化程度)、尿失禁的症状及其严重程度、尿失禁对患者心理的影响、尿失禁对日常生活的影响、尿失禁对性生活的影响、尿失禁对生活质量的影响。结果:病人对此疾病认识严重缺乏,尿失禁对患者生理、心理、日常生活、性生活及生活质量有较大的影响。结论:应采取措施提高人们对尿失禁的认识。提高公众的健康意识、提高医生的理念、技术,提高妇女的生活质量,实现真正意义上的健康。     

综合护理干预对脑梗死后尿失禁患者排尿功能恢复的影响

目的：探讨综合护理干预措施对脑梗死后尿失禁患者排尿功能恢复的影响。方法：随机选取急性脑梗死后尿失禁患者65例,分两组,观察组35例给予综合护理干预,包括心理干预、情感护理、膀胱自控排尿功能训练等,对照组30例仅给予常规护理,比较两组患者1、3、6及9周不同时间段患者排尿功能的恢复情况及尿路感染发生率。结果：观察组总有效率达94.29%,显著高于对照组（70.00%）,比较差异有统计学意义（P〈0.05）;在1、3周时两组患者自控排尿能力改善程度比较差异无统计学意义（P〉0.05）,但综合干预护理后第6、9周,观察组患者自控排尿能力明显改善程度,尿路感染发生率明显降低,与对照组比较差异具有统计学意义（P〈0.05）。结论：综合护理干预配合早期排尿功能的康复训练,有利于脑梗死后尿失禁患者膀胱排尿能力的恢复,减少并发症的发生。     

不同因素对产妇产后尿失禁及生活质量的影响

目的探讨不同因素对产妇产后尿失禁和生活质量的影响。方法选取2017年6月至2018年6月在我院分娩后6～8周复查的产妇318例,按照分娩方式分为剖宫产组、阴道顺产组和儿头吸引组,比较三组的尿失禁发生率;根据产妇是否发生尿失禁分为尿失禁组和非尿失禁组,比较两组产妇的生活质量评分。结果儿头吸引组产妇的尿失禁发生率显著高于阴道顺产组、剖宫产组,阴道顺产组的尿失禁发生率显著高于剖宫产组(P <0.05)。318例产妇产后发生尿失禁61例,尿失禁组产妇的情感职能、健康状况、社会职能评分及总分均显著低于非尿失禁组产妇(P <0.05)。结论儿头吸引、阴道顺产相对于剖宫产能增加产后尿失禁发生率,尿失禁对产妇的生活质量具有显著的不良影响。     

Urinary Incontinence in Women Under 65: Quality of Life, Stress Related to Incontinence and Patterns of Seeking Health Care

OBJECTIVE: We sought to describe quality of life, psychological stress and patterns of seeking health care (PSHC) among young and middle-aged women experiencing urinary stress incontinence (USI). Reasons and variables associated with delay in seeking care were also investigated. METHODS: A sample of 131 patients, aged 22-65, filled out a questionnaire consisted of: SF-36, stress related to incontinence, patterns of seeking health care questionnaires and a 10 cm visual analogue scale (VAS) measuring perceived suffering from USI (0 indicating absence of suffering while 10 indicating most severe suffering). RESULTS: Scores on eight domains of SF-36 were lower, compared to 405 Israeli healthy women (p < 0.001). Forty-one percent reported impairment in performing work and other activities. Mean scores on the VAS was 5.04 (SD: 2.59), 30% marked 7 cm and higher and 12.6% reported most severe suffering due to USI (scored 10 cm). Psychological stress related to incontinence was higher among the younger women and those with severe impairment to sexual activity. The majority of the sample (74%) delayed seeking help for at least a year, 46% delayed it for 3 years. Common reasons for delay were lack of time (36.3%), shame (15.7%) and fear of surgery (14.7%). Age, psychological stress, perceived suffering and social functioning (SF) were associated with patterns of seeking care. CONCLUSIONS: USI causes suffering and impaired quality of life among young women. Reluctance to seek help highlights the need to promote women's knowledge of treatment options and cure prospects.     

Is a Generic Quality of Life Instrument Helpful for Evaluating Women with Urinary Incontinence?

Objectives: The aim of this study was to determine whether a generic health outcome instrument would be helpful for evaluating women with stress urinary incontinence (UI) combined with or without urge UI. Methods: A total of 109 women with UI and 80 controls participated in the study. Health-related quality of life (QOL) was measured using the Medical Outcomes Study 36-Item Short-Form General Health Survey (SF-36) and the Incontinence Quality of Life (I-QoL) questionnaire. Results: Among eight domains of the SF-36 questionnaire, only four domains, namely, ‘role-physical functioning’ (p<0.05), ‘vitality’ (p<0.05), ‘mental health’ (p<0.05) and ‘bodily pain’ (p<0.05) were significantly different between the groups. Comparing the I-QoL sores in the two groups, patients with UI had significantly poorer subscale scores of I-QoL than the controls (p<0.05 for all domains). When women with UI were subdivided into groups of stress and mixed UI, only 2 domains of the SF-36 questionnaire, ‘role-physical functioning’ (p<0.05) and ‘bodily pain’ (p<0.05), were significantly different. The mixed UI group had higher scores only on these two domains compared to the stress UI group. In the ‘role-physical functioning’ domain, there was no significant difference between the mixed UI group and the controls. In ‘bodily pain’ domain, there was no significant difference between the stress UI group and the controls. The mixed group had the highest scores observed. Patients with mixed UI had significantly lower total scores compared to those with stress UI, including the subscale score of ‘avoidance behavior’ of the I-QoL. Among eight domains of the SF-36, only ‘physical functioning’ (r = 0.281, p<0.01) and ‘social functioning’ (r = 0.239, p<0.05) were weakly correlated with ‘psychological impact’ of the I-QoL. Conclusion: Our findings show that the generic QOL instrument is not sensitive measure of QOL in women with UI.     

等离子前列腺电切术和剜除术治疗前列腺增生症术后尿失禁发生率的比较研究

目的：比较分析等离子前列腺电切术（PKRP）和剜除术（PKEP）治疗前列腺增生症术后尿失禁发生率,及预防心得。方法：将本院2009年8月-2012年7月收治的前列腺增生症患者213例随机分成两组,顺行电切组121例,剜除组92例,对两组术后随访6个月,比较两组尿失禁发生率和术后恢复时间。结果：剜除组术后暂时性尿失禁发生率高于顺行电切组,比较差异具有统计学意义（P〈0．05）,但是均未出现永久性尿失禁。结论：经尿道等离子前列腺剜除术治疗前列腺增生症术后尿失禁发生率较传统顺行电切术高。