摘要
目的 观察个体化膀胱功能训练治疗脊髓损伤后神经源性膀胱患者的疗效.方法 将62例神经源性膀胱患者随机分为干预组（32例）及对照组（30例）.干预组患者在进行简易尿流动力学检测过程中测定膀胱安全容量,并制订安全、有效的个体化膀胱功能训练方案.对照组患者在测定膀胱残余容量后,则给予常规膀胱功能训练.观察并对比2组患者达到膀胱平衡所需时间及入选1个月、3个月及6个月期间尿路感染发生情况.结果 2组患者经治疗后均能达到膀胱平衡,干预组颈髓损伤患者达到膀胱平衡所需时间为（33.88±5.62）d,胸髓损伤患者为（34.75±6.63）d,腰骶髓损伤患者为（32.23±6.34）d,均较对照组达到膀胱平衡所需时间[颈髓损伤患者为（45.87±7.86）d,胸髓损伤患者为（44.32±7.55）d,腰骶髓损伤患者为（40.56±8.67）d]明显缩短（P＜0.05）.干预组患者尿路感染发生率在入选1个月（12.5％）、3个月（6.3％）及6个月时（3.1％）均显著低于对照组水平（P＜0.05）.结论 对脊髓损伤后神经源性膀胱患者进行个体化膀胱功能训练,能促使患者尽快恢复膀胱平衡并抑制尿路感染发生,该疗法值得临床推广、应用.
Objective To explore the effectiveness of individualized bladder training therapy in alleviating neurogenic bladder dysfunction after spinal cord injury.Methods Sixty-two patients with neurogenic bladder dysfunction were randomly assigned to a treatment group or a control group,each of 30 patients.The treatment group was given individualized bladder training based on a simple urodynamics test for determining the safe bladder volume of each patient,while the control group patients were provided with regular bladder training.Bladder balance time and urinary tract infection rates were observed at 1,3 and 6 months after the treatment had ended.Results All the patients in both groups could achieve bladder balance after their treatment,but he time needed for the treatment was significantly shorter for those receiving individualized training programs [（33.88 ± 5.62） d,（34.75 ± 6.63） d,and （32.23 ± 6.34）d,respectively for patients with cervical,thoracic and lumbosacral cord injury] than that of the control group [（45.87 ± 7.86） d,（44.32 ± 7.55） d and （40.56 ± 8.67） d,respectively for cervical,thoracic and lumbosacral cord injury].The incidence of urinary tract infection was also significantly lower than in the control group （P 〈 0.05）.Conclusion Individualized bladder training in patients with neurogenic bladder caused by spinal cord injury can promote quicker recovery of bladder balance and reduce the risk of urinary tract infection.It is worth applying in clinical practice.
出处
《中华物理医学与康复杂志》
CAS
CSCD
北大核心
2015年第1期48-51,共4页
Chinese Journal of Physical Medicine and Rehabilitation
基金
浙江省嘉兴市科技局研究基金（2012AY1071-4）
