出生时轻度窒息史对出生七天后新生儿排尿方式的影响

目的 探讨出生时轻度窒息对出生7 d后新生儿排尿方式的影响.方法 选取出生28 d内、无下尿路疾息的34例有轻度窒息病史的新生儿及33例无窒息史新生儿,其中窒息史组正常体重(ANW)16例,体重(2.83土0.31)kg,年龄(11.1±2.7)d;低体重(ALW)18例,体重(1.68±0.54)kg,年龄(14.5±7.6)d.无窒息史组正常体重(NANW)18例,体重(3.24±0.43)kg,年龄(11.8±2.2)d和低体重(NALW)15例,体重(1.88±0.32)kg,年龄(15±8.3)d.各组均进行12 h(9am～9 pm)自由排尿观察,记录排尿频率、每次排尿量、B超测量排尿后残余尿量、排尿时是否处于睡眠状态.结果 共记录排尿533次.ANW组排尿次数(9.5±2.7)次,明显高于NANW组(7.7±2.3)次(P＜0.05),但排尿量和残余尿量差异无统计学意义.ALW组与NALW组排尿次数、排尿量和残余尿量差异无统计学意义.ANW组排尿次数(9.5±2.7)次、排尿量(17.7±5.8)ml,明显高于ALW组(7.7±2.3)次,(13.5±6.1)ml,但残余尿量差异无统计学意义.NANW组排尿量(21.1±11.0)ml明显高于NALW组(13.1±6.2)ml(P＜0.05),但排尿次数和残余尿量差异无统计学意义.膀胱排空率和排尿时清醒百分率在ANW组和NANW组中均较高,二者差异不明显;在ALW组和NALW组中差异也不明显.结论 新生儿出生时轻度窒息史可能对正常体重儿排尿次数有明显影响;对新生儿排尿量和残余尿量影响不大.

Abstract：

Objective The aim of this study was to investigate the effect of mild asphyxiation (A) on voiding pattern of newborns. Methods A total of 67 newborns, 34 cases with mild asphyxiation and 33 cases normal, without low urinary tract pathological abnormalitiesdiseases, single birth,hospitalized in NICU were included in this study. They were divided into 4 groups: 16 cases of asphyxiation with normal weight(ANW), 18 cases of asphyxiation with low weight(ALW), 18 cases of no asphyxiation with normal weight (NANW)and 15 cases of no asphyxiation with low weight (NANW). Each group undertook 12 hours (9:00am ～9:00 pm) free voiding observation. We recorded, recording voiding time, the voiding volume, post-voiding residual urine (PVR) by B ultrasound, empty voiding and awake or sleep percentage at voiding. Results Five hundred and thirty three episodes of voiding were recorded. The voiding frequency in ANW (9. 5 ± 2. 7)times is higher than those of NANW(7. 7 ± 2. 3)times (P＜0. 05), but the voiding volume and PVR are no significant difference (P＞0. 05)between 2 groups. The voiding frequency, volume and PVR in ALW and NALW are no significant difference(P＞0.05). The voiding frequency and volume in ANW(9. 5 ± 2. 7)times, (17. 7± 5. 8)ml respectively is higher than ALW(7. 7 ± 2. 3)times, (13. 5 ± 6. 1 )ml (P＜0. 05), but PVR are no significant difference(P＞0. 05). The voiding volume in NANW (21.1 ± 11.0)ml is higher than NALW( 13. 1 ± 6. 2)ml(P＜0. 05), but the voiding frequency and PVR are no significant difference(P＞0. 05). Voiding empty and awake percentage is higher in ANW and NANW, but no significant difference; voiding empty and awake percentage in LNW and NALW are no significant difference.Conclusions Mild asphyxiation induced more voiding frequencies in ANW newborn but it has little impact on voiding volume, PVR, empty voiding percentage and awake voiding percentage in all newboms. Its mechanism is unclear.     

平卧位排尿训练对腰椎间盘突出症患者术后排尿方式的影响

目的 探讨行为干预平卧位排尿训练对腰椎间盘突出患者术后排尿方式的影响.方法 将105例择期手术的住院患者按住院时间的先后随机分为观察组55例(行为干预平卧位排尿)和对照组50例(常规术前宣教),比较两组患者术后的排尿方式(自行排尿、诱导排尿或导尿)及首次排尿时间.结果 观察组患者术后均能自行排尿,排尿方式差异有显...     

简易视觉生物反馈装置应用于脊髓损伤患者自主排尿训练的护理

应用自制简易视觉生物反馈装置,对33例脊髓损伤后神经源性膀胱患者进行排尿功能训练。通过采取有效沟通、标注训练目标、预防泌尿系感染、记录排尿日志的方法,提高了患者参与训练的积极性,培养了患者自我管理的能力。33例经过4周训练,29例有自主排尿,残余尿量≤100ml。     

The prevalence of clinically meaningful overactive bladder: bother and quality of life results from the population-based FINNO study

Background

Wide variation exists in prevalence estimates of overactive bladder (OAB) syndrome.

Objective

To determine how the frequency of urinary urgency or urgency urinary incontinence (UUI)—the cornerstone symptoms of OAB—affects symptom-related bother, health-related quality of life (HRQL), and ultimately clinically meaningful prevalence.

Design, setting, and participants

Questionnaires were mailed to 6000 subjects (18–79 yr of age) randomly identified from the Finnish Population Register in 2003–2004.

Measurements

The frequency (scale: never, rarely, often, always) and bother (scale: none, small, moderate, major) of urgency and UUI were assessed using the Danish Prostatic Symptom Score (DAN-PSS). HRQL was measured with the generic 15D instrument. For HRQL analyses, respondents were classified according to six symptom categories by frequency of urgency and UUI.

Results and limitations

Of those subjects queried, 62.4% responded to the survey (53.7% female). Any urgency was reported by more than half of all respondents (54.2% [95% confidence interval (CI), 51.6–56.7] of men; 56.9% [95% CI, 52.9–61.0] of women), whereas any UUI was reported by one in nine men (10.7% [95% CI, 8.9–12.4]) and one in four women (25.7% [95% CI, 22.8–28.7]). However, only one in seven of all respondents with urgency and less than one in three with UUI reported at least moderate bother. With increasing OAB severity, statistically significant decreases were found in the total 15D score and on all 15D dimensions (p < 0.001 for all). Reporting often urgency without UUI or rare urgency with rare UUI is associated with a clinically important decrease in HRQL. Although the response proportion was high, approximately one-third of those contacted did not participate.

Conclusions

Increased severity of urgency and UUI is associated with a statistically significant and clinically important decrease in HRQL. Assessing bother associated with OAB drastically modifies the measured OAB prevalence and accounts for variation among studies.     

骶神经电针刺激对马尾神经损伤患者神经源性膀胱排尿功能重建的意义

目的：观察骶神经电刺激对马尾神经损伤后患者神经源性膀胱排尿功能重建的影响。方法2012年9月至2013年7月,我院收治的马尾神经损伤致神经源性膀胱的患者20例,其中男16例,女4例,年龄37.37（17～63）岁。所有患者入院后经实验室及生化检查排除上尿路积水、尿路感染及结石等并发症后给予骶神经电针刺激,20次为1个疗程。再行间歇导尿配合行为疗法、扳机点叩击排尿法以及 Kegel 训练（盆底肌训练）,并做好排尿日记。在治疗结束后从导尿到首次反射排尿用时、平衡膀胱建立的时间、排尿量及残余尿量比、膀胱安全容量生活质量评估（ quality of life,QOL ）、生化及影像学检查等方面对患者进行功能评价。并在治疗结束后半年随访,对资料进行整理分析。结果本组未发现严重副作用患者,出现漏尿8例,其中有2例因反复低热、全身乏力以及不能接受家庭清洁导尿而最终选择手术治疗。首次排尿用时（7.80±4.82）天。平衡膀胱建立用时（22.20±7.17）天,有效建立平衡膀胱率75%。反射性排尿量与残余尿量比治疗结束时和治疗结束后半年均有明显提升,分别为4.06±5.21、7.51±6.80。在膀胱安全容量方面,治疗前后变化不大（ P＞0.05）。QOL评分由治疗前（4.35±1.27）分减少到治疗结束时（2.40±0.99）分（ P＜0.05）,治疗结束后半年更低为（1.15±2.45）分（ P＜0.05）。在评价菌尿的指标中,WBC及BAC检出率均明显降低,分别由治疗前90%、80%降低到治疗结束时的65%、57.9%以及治疗结束后半年的40%、40%（ P＜0.05）;治疗结束时尿菌落数82.6%与治疗前92.6%比较,变化不大（ P＞0.05）,但治疗结束后半年菌落数明显减少到50%,和治疗前比较,差异有统计学意义（ P＜0.05）;而尿路出血指标RBC检出率及B超显示上尿路积水情况治疗前、治疗结束时、治疗结束后半     

长时间留置尿管拔管时注入药物对排尿影响的研究

目的研究长时间留置尿管患者拔尿管时注入药物对排尿功能的影响。方法将216例长时间留置尿管患者随即分为三组,常规组(65例),冲洗组(76例),注药组(75例)。常规组患者拔尿管时按医嘱予常规操作拔除尿管;冲洗组拔尿管前排空膀胱,以生理盐水加庆大霉素行膀胱冲洗;注药组拔尿管前注入甲泼尼龙、利多卡因、丁胺卡那。比较常规组与注药组、冲洗组与注药组患者拔尿管后第1次排尿时尿痛、排尿困难及排尿障碍发生率。结果拔尿管后第1次排尿时尿痛、排尿困难及排尿障碍发生率比较,常规组与注药组、冲洗组与注药组,差异匀有显著性意义(P<0.05)。结论长时间留置尿管患者拔管时注入甲泼尼龙、利多卡因、丁胺卡那能改善拔管后排尿自觉症状,减轻患者痛苦。     

肾穿术6小时后下床排尿对患者术后并发症的影响

目的探讨经皮肾脏穿刺组织活检术(肾穿术)6小时后患者下床排尿对术后并发症影响。方法将86例行肾穿术的患者分为实验组和对照组各43例,两组在术后6小时采取不同的排尿方法:下床排尿(实验组)和卧床排尿(对照组),观察两种排尿方法对术后并发症及尿潴留的影响。结果术后并发症在两组之间无统计学差异(P>0.05);而尿潴留情况,实验组低于对照组(P<0.05)。结论肾穿术6小时后患者下床排尿不会增加术后并发症,且明显降低术后尿潴留。     

芒针配合膀胱功能训练治疗脊髓损伤后小便障碍的临床应用研究

目的：观察芒针配合膀胱功能训练治疗脊髓损伤后小便障碍的临床疗效。方法：将近2年来我科（针灸康复科）50例脊髓损伤导致小便障碍的患者随机分为治疗组25例,对照组25例,治疗组用芒针配合膀胱功能训练治疗,对照组单独采用膀胱功能训练,两组治疗前后用疗效评定量表判定疗效。结果：芒针配合膀胱功能训练治疗脊髓损伤后小便障碍较对照组具有很好的临床疗效（P〈0．05）,值得临床推广使用。     

新生儿缺血缺氧性脑病对早产儿排尿方式的影响

目的 探讨新生儿缺血缺氧性脑病(HIE)对早产儿排尿方式的影响.方法 选取出生后4～15d确诊为新生儿缺血缺氧性脑病早产儿48例,男34例,女14例,孕(32.1±0.7)周,出生时体重(2.5±0.3)kg.选取同期出生后4～15d无缺血缺氧性脑病的33例早产儿为对照组,男22例,女11例,孕(32.3±1.4)周,出生时体重(2.4±0.5)kg.记录4h(早上8点～10点)排尿情况,包括排尿量、残余尿量、排尿次数等参数,同时记录饮奶量、液体输入量及摄入时间,液体摄入量按标准进行.结果共记录了248次排尿,其中HIE组136次,对照组112次.HIE组排尿量和排空比例分别为(14.8±8.3)ml和11.6％,均显著小于对照组[(16.5±9.2)ml和24.3％];而HIE组的排尿次数、平均残余尿量分别为(2.8±1.1)次、(1.5±1.3)ml,对照组为(3.3±1.2)次、(1.7±0.9)ml,两者之间的差异无统计学意义.结论 缺血缺氧性脑病可使早产儿出现一定程度排空和储尿障碍,表现为每次排尿量及排空比例降低.     

家庭尿流率测定在下尿路症状患者评估中的研究进展

尿流率测定是一种无创和相对便宜的检查项目,对于怀疑有下尿路功能障碍的患者来说,它是一项首选且必不可少的筛查项目。这种简单的尿动力检查方法,可以客观地反映下尿路的排尿情况,包括排尿期膀胱和尿道的功能以及它们之间的相互关系,从而获得下尿路症状(lower urinary tract symp-toms,LUTS)患者一些客观和定量的排尿信息,有助