简易膀胱容量压力测定法在缺血性脑卒中留置尿管患者膀胱功能评估中的应用

发布时间：2019-02-27 21:12

【摘要】：目的探讨简易膀胱容量压力测定法在脑卒中留置尿管患者膀胱功能评估中的应用效果,为脑卒中患者早期拔除尿管提供依据。方法观察组纳入105例缺血性脑卒中并发充溢性尿失禁留置尿管患者,应用简易膀胱容量压力测定法对其起病4 d后行膀胱功能的评估,并将观察组分配灌注不同容量梯度(150 mL、250mL、350 mL、450 mL),以膀胱正常充盈期的压力(15±1)cmHO_2为判断膀胱功能康复的标准及拔除尿管的时机。对照组纳入66例缺血性脑卒中并发充溢性尿失禁留置尿管患者,发病后4 d开始夹闭尿管,有尿意后拔除尿管,比较两种方法对留置尿管的时间、尿路感染发生率、一次性拔管成功率的差异,并分析不同灌注容量组之间对患者测压的影响。结果观察组留置尿管时间明显短于对照组(P0.05),两组的尿路感染发生率、一次性拔管成功率差异无统计学意义(P0.05)。在观察组的4个亚组中,350 mL组的留置尿管时间显著短于150 mL组(P0.05),450 mL组的一次性拔管成功率显著低于其余3组(P0.05)。结论简易膀胱容量压力测定法可作为早期判断缺血性脑卒中患者膀胱功能的恢复情况的可靠指标,推荐膀胱测压容量为350 mL。
[Abstract]:Objective to investigate the effect of simple bladder volume pressure measurement in bladder function evaluation of patients with cerebral apoplexy with indwelling catheter, and to provide evidence for early removal of urinary catheter in patients with cerebral apoplexy. Methods 105 patients with ischemic stroke complicated with overflowing urinary incontinence indwelling urinary catheter were enrolled in the observation group. The bladder function was evaluated 4 days after the onset of the disease by a simple bladder volume pressure test. According to the pressure of normal filling period of bladder (15 卤1) cmHO_2, the different volume gradient (150 mL,250mL,350 mL,450 mL),) was used as the criterion to judge the recovery of bladder function and the time of removal of urinary catheter in the observation group. 66 patients with ischemic stroke complicated with overflowing urinary incontinence indwelling catheter were enrolled in the control group. 4 days after onset, the catheter was clamped and the urinary catheter was removed after the onset of the disease. The time of indwelling urinary catheter and the incidence of urinary tract infection were compared between the two methods. The difference of the success rate of one-time extubation was analyzed, and the influence of different perfusion volume groups on the pressure measurement was analyzed. Results the time of indwelling catheter in the observation group was shorter than that in the control group (P0.05). There was no significant difference in the incidence of urinary tract infection and the success rate of one-time extubation between the two groups (P0.05). In the four subgroups of the observation group, the indwelling time was significantly shorter in the 350 mL group than in the 150 mL group (P0.05), and the success rate of one-time extubation in the 450 mL group was significantly lower than that in the other 3 groups (P0.05). Conclusion the simple bladder volume pressure measurement can be used as a reliable index to judge the recovery of bladder function in patients with ischemic stroke in the early stage. It is recommended that the bladder pressure measurement capacity be 350 mL..
【作者单位】：东莞市人民医院神经内科
【基金】：东莞市科技局科研基金资助项目(编号:201410515000086)
【分类号】：R473.74

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