系统性康复护理在脊髓损伤患者神经源性膀胱中的临床应用研究

目的探讨系统性康复护理在创伤性脊髓损伤(traumatic spinal cord injury,TSCI)患者神经源性膀胱(neurogenic bladder,NB)中的临床应用。方法将2017年6月—2018年3月宁波大学医学院附属医院及宁波市第六医院收治的60例TSCI并发NB的患者作为研究对象,采用随机区组设计,按入院时间段分为干预组和对照组,30例对照组采用常规护理,30例干预组在常规护理的基础上,给予个体化膀胱功能训练、间歇导尿示范、心理干预、饮食护理、随访监督等系统性康复护理。连续干预6个月后评估2组患者的生活质量(quality of life,QOL)、膀胱功能评价、尿路感染发生率、护理工作满意率。结果 2组患者并发尿路感染比较差异无统计学意义,但干预组发生感染的例数要低于对照组。干预组达到膀胱平衡状态所需时间明显短于对照组(P<0.05),干预组护理工作满意率也较对照组明显提高(P<0.05)。2组QOL比较,缺陷与强制方面差异无统计学意义。干预组在焦虑与情感方面明显好于对照组(均P<0.05)。结论系统性康复护理干预可显著缩短NB患者达到膀胱平衡状态所需时间,减少尿路感染的发生,有利于减轻患者的焦虑状态,提高患者的生活质量和对护理工作的满意率,有效提高了神经源性膀胱康复效果。

Clinical application of systematic rehabilitation nursing in neurogenic bladder of patients with traumatic spinal cord injury

Objective To study the clinical application of systematic rehabilitation nursing in neurogenic bladder of patients with traumatic spinal cord injury(TSCI). Methods Sixty patients with TSCI admitted to the Affiliated Hospital of Medical College of Ningbo University from June 2017 to March 2018 were divided into intervention group and control group according to the random group design, by admission period. The control group of 30 patients were given routine nursing. On the basis of routine nursing, the intervention group of 30 patients were given individualized bladder function training, intermittent catheterization demonstration, psychological intervention, diet care, follow-up supervision and other systematic rehabilitation care. The quality of life (QOL), bladder function, incidence of urinary tract infection and satisfaction rate of nursing were evaluated after 6 months of continuous intervention. Results There was no significant difference in urinary tract infection between the two groups, but the number of infections in the intervention group was lower than that in the control group. The time required for the intervention group to reach the equilibrium state of the bladder was significantly shorter than that of the control group (P<0.05), and the satisfaction rate of the nursing work in the intervention group was also significantly higher than that of the control group (P<0.05). There was no significant difference in defects and coercion between the two groups. The intervention group was significantly better than the control group in terms of anxiety and emotion (both P<0.05). Conclusion Systematic rehabilitation nursing intervention can significantly shorten the time required for NB patients to reach the equilibrium state of the bladder, reduce the incidence of urinary tract infections, help to reduce the anxiety of patients, improve the quality of life of patients and the satisfaction rate of nursing work, and effectively improve the healing effect of neurogenic bladder.