【摘要】 目的:探讨无菌间歇导尿(Sterile Intermittent Catheterization,SIC)更换卧位对脊髓损伤(spinal cord injury,SCI)致神经源性膀胱功能障碍(neurogenic bladder,NB),泌尿系感染(urinary tract infection,UTI)并发症的影响。方法:SCI符合美国脊髓损伤学会(American Spinal Injury Association,ASIA)2011年标准;NB符合亚洲神经源性膀胱诊断治疗指南(2011版)的诊断标准。患者115例患者分为对照组56例,观察组59例,2组患者制定饮水计划并书写排尿日记,接受常用的膀胱功能训练,SIC,观察组导尿后采取更换卧位,分别叩击耻骨上、骶尾部和右侧/或左侧臀部,2次夹闭尿管、3次开放彻底引流尿液。观察指标:血常规、尿常规、细菌培养、肾功能、B超等辅助检查,每次导尿时观察尿液的物理状态。结果:2组患者UTI的发生随间歇导尿呈减少趋势,但对照组经过3周的间歇导尿UTI发生并无减少。观察组与照组比较3周后有显著性差异(P∠0.01)。结论:SIC更换卧位引流尿液,能有效降低SCI致NB患者UTI的发生。更多还原

【Abstract】 Objective: To discuss sterile Intermittent Catheterization replace the lying position of spinal cord injury,cause neurogenic bladder dysfunction urinary tract infection complications. Methods: SCL conforms to the American Spinal Injury Association 2011 standard; NB in Asian neurogenic bladder guide( 2011) diagnostic criteria for the diagnosis and treatment. 56 cases patients,115 patients were divided into control group,59 cases of observation group,2 groups of patients developed a plan of drinking water and voiding diary writing,commonly used bladder function training,SIC,Observation group after urethral catheterization to replace recumbent position,respectively the taps on the pubic bone, the tail and / or on the right side on the left side of the hips,,turn off 2 times,3 times open drainage of urine,the urine drainage thoroughly. Observation indexes: blood routine,urine routine,bacteria culture,kidney function,B ultrasonic auxiliary examination,each time observes the physical state of the urine catheter. Results: Two groups the incidence of urinary tract infection in patients with intermittent catheterization showed a trend of decrease,but the control group after 3 weeks of intermittent catheterization and urinary tract infections occur no less. Observation: group compared with group according to the significant difference in 3 weeks( P < 0. 01). Conclusion: SIC replaced decubitus drainage of urine, could effectively reduce the urinary tract infection in patients with SCI to NB.更多还原