康复训练介入时间对脑卒中后排尿功能障碍康复的影响

目的:探讨早期和晚期康复训练对脑卒中后排尿功能障碍康复的影响.方法:126例脑卒中并发排尿功能障碍患者,早期和晚期康复组各63例,早期康复组在神经病学体征稳定后1～4 d开始介入,晚期康复组在5～10 d介入.两组采用相同的康复方法,包括水出入量控制训练,尿道括约肌控制力训练,排尿反射训练,代偿性排尿方法训练,留置尿管期的膀胱充盈训练和心理康复.排尿功能的评估:记录每天排尿的尿量和次数;每次排尿的尿量与时间;是否有尿意;压迫腹部刺激会阴是否能引起排尿;排尿有关的末梢神经功能是否正常.结果:经3～15d治疗,两组排尿功能均显著改善,排尿功能康复,但早期康复组改善时间明显优于晚期康复组(P＜0.05).结论:早晚期康复训练均能显著改善排尿功能,但早期康复训练使恢复进程加快.

The effect of rehabilitated physical exercise in different time on restoration of urinary dysfunction

Objective: To study the effect of rehabilitated physical exercise in different time on restoration of urinary dysfunction after stroke.Methods: One hundred and twenty six patients with complication of urinary dysfunction resulted from stroke were divided into two groups(n=63 for each).The intervention was taken within 1 to 4 days and 5 to 10 days respectively when physical signs was stable in neurology,and the same rehabilitation methods were carried out including controlling of intake and excretion of amount of water,exercise of capacity of urethral sphincter,strengthening micturition reflex,compensated urination,exercise of filling of bladder with catheter retained and psychological rehabilitation.The assessment of urinary function was evaluated as followings: recording the amount of urine and times each day;amount of urine and time each time;urinary intention;occurring of micturition induced by oppressing abdomen and stimulating perineum,etc.Results: The obvious improvement of urinary function was found in the two groups through 3-15 days rehabilitation,but the improvement was much better in the early rehabilitation group than that in the delayed group(P<0.05).Conclusion: Both the rehabilitation in early stage and later stage can improve the urinary function,and early rehabilitation has the much effect on the process of improvement.