PDCA循环管理联合个体化训练对脊髓损伤后神经源性膀胱患者康复效果的影响

目的 探讨PDCA循环管理联合个体化训练对完全性脊髓损伤（SCI）后神经源性膀胱患者康复疗效的影响.方法 将60例完全性SCI患者采用随机数字表法分为观察组和对照组,每组30例.对照组患者给予常规护理,观察组在PDCA管理下结合患者损伤平面给予个体化膀胱功能训练,比较两组患者膀胱功能康复效果、自主排尿时间、残余尿量、ADL评分及尿路感染发生率.结果 经康复护理训练后,观察组中颈髓、胸髓、腰髓损伤患者的自主排尿时间分别为（36.78±9.41）,（43.85±10.17）,（52.26±7.52）d,对照组分别为（51.02±8.59）,（59.53±11.43）,（63.09 ±8.18）d,两组比较差异有统计学意义（t值分别为6.12,5.61,5.34；P＜0.05）；观察组尿路感染发生率为16.67％,对照组为46.67％,两组比较差异有统计学意义（x2=6.24,P＜0.05）；观察组患者出院时平均ADL评分为（60.59±15.64）分,高于对照组的（50.07 ±14.85）分,两组比较差异有统计学意义（t=2.67,P＜0.05）.结论 PDCA管理联合个体化训练可以有效恢复完全性SCI患者膀胱生理功能,减少尿路感染的发生率,提高患者的生活质量,缩短康复周期.

Effect of PDCA combination with individualize training on rehabilitation of patients with neurogenic bladder after spinal cord injury

Objective To explore the effect of PDCA combination with individualize training on rehabilitation of patients with neurogenic bladder after spinal cord injury （SCI）.Methods Sixty patients with SCI were randomly divided into control group and experimental group,each with 30 cases.The patients in the control group received routine nursing care.Patients in the experimental group received PDCA circulation combined with individualize nursing.The effect of bladder function,the time of self-voiding,residual urine volume （RUV）,the mark of ADL,and the incidence of infection of urinary system were recorded and compared between two groups.Results After individualize training on rehabilitation of patients,the time of self-voiding in SCI patients with cervical,thoracic spinal cord,lumbar injury were respectively （36.78 ± 9.41）,（43.85 ±10.17）,（52.26 ± 7.52） d in the experimental group,and （51.02 ± 8.59）,（59.53 ± 11.43）,（63.09 ±8.18） d in the control group,and the differences were statistically significant （t =6.12,5.61,5.34,respectively; P ＜0.05）.The incidence of infection of urinary system was 16.67％ in the experimental group,and 46.67％ in the control group,and the difference was statistically significant （x2 =6.24,P ＜ 0.05）.The mark of ADL was （60.59 ± 15.64） in the experimental group when the patients discharged from hospital,and was higher than （50.07 ± 14.85） in the control group,and the difference was statistically significant （t =2.67,P ＜0.05）.Conclusions PDCA combination with individualize training can effectively recover bladder physiological function in patients with SCI,reduce the incidence of infection of urinary system,improve the patients＇ quality of life,and shorten the recovery cycle.