摘要
目的:探讨脊髓损伤患者上尿路功能损害的相关因素。方法:回顾性分析2002年1月至2009年12月期间于中国康复研究中心住院的脊髓损伤患者病历记录,根据诊断标准分为上尿路功能损害组和无上尿路功能损害组,比较两组之间人口学资料(性别、年龄)、脊髓损伤资料(损伤原因、损伤节段、损伤程度)、一般泌尿系统情况(膀胱管理方式、尿常规、尿培养、症状性泌尿系感染、B超、血肌酐)、影像尿动力学资料(膀胱顺应性、膀胱稳定性、膀胱感觉、逼尿肌括约肌协同性、逼尿肌漏尿点压力、最大膀胱测压容积、相对安全膀胱容量、最大尿流率、最大尿道闭合压)等指标之间的差异,进行多因素非条件Logistic回归模型分析,筛选出脊髓损伤患者上尿路损害的危险因素。结果:上尿路功能损害组与无上尿路功能损害组比较,两组患者在脊髓损伤节段(χ2=8.840,P=0.031)、膀胱管理方式(χ2=11.362,P=0.045)、尿常规(χ2=17.983,P=0.000)、症状性泌尿系感染(χ2=64.472,P=0.000)、膀胱顺应性(χ2=6.531,P=0.011)、膀胱感觉(χ2=11.505,P=0.009)、最大膀胱测压容积(t=2.209,P=0.043)、逼尿肌括约肌协同失调(χ2=4.247,P=0.039)等方面差异有统计学意义。多因素非条件Logistic回归分析结果显示:膀胱管理方式(OR=1.114,P=0.006)、症状性泌尿系感染(OR=1.018,P=0.000)、膀胱顺应性(OR=1.588,P=0.040)、逼尿肌括约肌协同失调(OR=1.023,P=0.034)等指标是影响脊髓损伤患者上尿路功能的关键因素。结论:症状性泌尿系感染、膀胱低顺应性、逼尿肌括约肌协同失调及不合理的膀胱管理方式等是脊髓损伤患者上尿路功能损害的危险因素。
Objective：To evaluate the related factors of upper urinary tract deterioration in spinal cord injured patients. Methods： Medical records of spinal cord injured patients from Jan. 2002 to Sep. 2009 were retrospectively reviewed. All the patients were divided into the upper urinary tract deterioration group and non-deterioration group according to the diagnostic criteria. Indexes such as demographic char- acteristic （gender, age）, spinal cord injury information （cause, level, completeness）, statuses of urina- ry tract system （ bladder management, urine routine, urine culture, ultrasound, serum creatinine, fever caused by urinary tract infection） and urodynamics information （bladder compliance, bladder stability, bladder sensation, detrusor sphincter dyssynergia, detrusor leak point pressure, maximum cystometric ca- pacity, relative safe bladder capacity, maximum flow rate, maximum urethra closure pressure） were com- pared between the two groups. Then Logistic regression analysis were performed. Results： There was sig- nificantly difference between the two groups in spinal cord injury level（x2 = 8. 840, P = 0.031 ） , bladder management （X2 = 11. 362, P = 0. 045 ）, urinary rutine （X2 = 17. 983, P = 0. 000）, fever caused by urina- ry tract infection （X2 = 64. 472, P = 0. 000）, bladder compliance （X2 = 6.531, P = 0.011 ）, bladder sen- sation（x2 = 11. 505, P = 0. 009 ）, maximum cystometric capacity （ t = 2.209, P = 0. 043 ）, and detmsor- sphincter dyssynergia（x2 = 4. 247, P = O. 039）. The multiple-factor non-conditional Logistic regression analysis showed that bladder management （ OR = 1.114, P = 0.006）, fever caused by urinary tract infec-tion（ OR = 1. 018, P = O. 000）, bladder compliance （OR = 1. 588, P = O. 040） and detrusor-sphincter dyssynergia （ OR = 1. 023, P = O. 034） were the key factors of upper urinary tract deterioration in spinal cord injured patients. Conclusion： Urinary tract infection, lower bladder compliance, detrusor-sphincter dys
出处
《北京大学学报（医学版）》
CAS
CSCD
北大核心
2014年第4期544-547,共4页
Journal of Peking University:Health Sciences
关键词
脊髓损伤
泌尿道
排尿障碍
危险因素
Spinal cord injuries
Urinary tract
Urination disorders
Risk factors
