摘要
目的评估依据膀胱安全容量法行间歇性导尿,在预防神经源性膀胱相关泌尿道感染中的作用。方法选取2017年1月—2018年12月就诊于某院的脊髓损伤或马尾神经损伤后神经源性膀胱患者,按照随机数字表法分为干预组和对照组。对照组予以常规间歇性导尿,导尿频率依据残余尿量确定。干预组予以间歇性导尿,导尿频率依据膀胱安全容量确定。比较两组患者的泌尿道感染发病率、细菌菌落计数及菌种构成、不良反应、残余尿量、膀胱安全容量及逼尿肌厚度。结果共纳入120例患者,干预组和对照组各60例,研究过程中干预组有1例因不能完成疗程而脱落。干预组泌尿道感染发病率(10.17%)低于对照组(28.33%),差异有统计学意义(χ^(2)=6.295,P=0.012);干预组尿培养细菌菌落数为(4.71±0.13)lg CFU/mL,低于对照组的(4.99±0.25)lg CFU/mL,差异有统计学意义(t=2.538,P=0.019);两组患者尿培养检出细菌均以G-菌为主。8周后,干预组患者的残余尿量、逼尿肌厚度均低于对照组,差异均有统计学意义(t值分别为2.323、3.412,均P<0.05);干预组患者膀胱安全容量高于对照组,差异有统计学意义(t=2.496,P=0.014)。两组患者的不良反应比较,差异无统计学意义(P>0.05)。结论依据膀胱安全容量行间歇性导尿,可以降低脊髓损伤后神经源性膀胱相关泌尿道感染发病率。
Objective To evaluate the efficacy of intermittent urethral catheterization based on safety bladder capacity for the prevention of neurogenic bladder-related urinary tract infection.Methods Patients with neurogenic bladder after spinal cord injury or cauda equina nerve injury in a hospital from January 2017 to December 2018 were selected and randomly divided into intervention group and control group according to random number table method.Control group was given routine intermittent urethral catheterization,catheterization frequency was based on post-void residual urine volume.Intervention group was given intermittent urethral catheterization,and catheterization frequency was based on the safety bladder capacity.Urinary tract infection rate,bacterial colony count and constituent,adverse reactions,post-void residual urine volume,as well as safety bladder capacity and detrusor wall thickness were compared between two groups of patients.Results A total of 120 patients were included in study,60 in intervention group and 60 in control group,one patient in intervention group withdrew catheterization because he could not complete treatment course.Urinary tract infection rate in intervention group was lower than that in control group(10.17%vs 28.33%,χ^(2)=6.295,P=0.012);the number of bacterial colonies in urine culture in intervention group was significantly lower than that in control group([4.71±0.13]lg CFU/mL vs[4.99±0.25]lg CFU/mL,t=2.538,P=0.019);Gram-negative bacteria were main pathogens isolated from urine culture of both groups.After 8 weeks,post-void residual urine volume and detrusor wall thickness in intervention group were both lower than those in control group(t=2.323 and 3.412,respectively,both P<0.05);safety bladder capacity in intervention group was significantly higher than that in control group(t=2.496,P=0.014).There was no significant difference in adverse reactions between two groups of patients(P>0.05).Conclusion Intermittent urethral catheterization based on safety bladder capacity can reduce neurogenic bladder-related urinary tract infection rate after spinal cord injury.
作者
张大伟
朱红军
柯俊
冯晓燕
陈玉红
刘怡
蔡萍
ZHANG Da-wei;ZHU Hong-jun;KE Jun;FENG Xiao-yan;CHEN Yu-hong;LIU Yi;CAI Ping(Department of Rehabilitation Medicine,The First Affiliated Hospital of Soochow University,Suzhou 215006,China;Department of Radiology,The First Affiliated Hospital of Soochow University,Suzhou 215006,China)
出处
《中国感染控制杂志》
CAS
CSCD
北大核心
2021年第10期903-908,共6页
Chinese Journal of Infection Control
基金
国家自然科学基金(81701669)。
关键词
神经源性膀胱
泌尿道感染
尿流动力学
间歇性导尿
膀胱安全容量
neurogenic bladder
urinary tract infection
urodynamics
intermittent urethral catheterization
safety bladder capacity
