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目的观察自行设计的膜片式气囊导尿管应用于卒中后神经源性膀胱的治疗效果。方法选取2015年1月至2016年6月神经内科住院确诊为卒中后神经源性膀胱的患者190例,按照患者不同处理方案分为治疗组(97例)和对照组(93例)。治疗组使用膜片式气囊导尿管进行治疗,对照组使用普通气囊导尿管进行治疗;比较组间不同时间点患者排尿及相关指标情况。结果排尿日记显示,治疗后1、2、3个月,治疗组尿失禁次数、排尿前和排尿后感觉异常次数低于对照组(P<0.05,P<0.01)。检查指标显示,治疗组治疗后1、2、3个月的残余尿量明显低于对照组(P<0.05,P<0.01),治疗后2、3个月的Barthel指数明显高于对照组(P<0.05,P<0.01),治疗后2、3个月的上尿路受累、下尿路感染及变形膀胱发生率较对照组有所下降,但差异无统计学意义(P均>0.05)。结论相比于传统的气囊导尿管,膜片式气囊导尿管在治疗卒中后神经源性膀胱可取得更好的疗效。
Objective To observe the therapeutic effect of a self-designed diaphragm-type balloon catheter on neurogenic bladder after stroke. Methods From January 2015 to June 2016, 190 patients with neurogenic bladder diagnosed as post-stroke neurological hospitalization were enrolled in this study. The patients were divided into treatment group (n = 97) and control group (n = 93) according to different treatment plans. The patients in the treatment group were treated with balloon catheter and the control group were treated with common balloon catheter. The voiding and related indicators of the patients at different time points were compared. Results Diuresis showed that the number of urinary incontinence, the number of sensory anomalies before and after urination in the treatment group were lower than those in the control group (P <0.05, P <0.01). The examination indicators showed that the residual urine volume in the treatment group was significantly lower than that in the control group 1,2,3 months after treatment (P <0.05, P <0.01), Barthel index at 2 and 3 months after treatment was significantly higher than that in the control group P <0.05, P <0.01). The incidences of upper urinary tract involvement, lower urinary tract infection and deformity bladder were lower than those of the control group at 2 and 3 months after treatment, but the difference was not statistically significant (all P> 0.05) . Conclusion Compared with the traditional balloon catheter, diaphragm balloon catheter in the treatment of neurogenic bladder after stroke can achieve better results.