47例脊髓损伤患者院外尿路护理体会.docVIP

精品论文 参考文献 47例脊髓损伤患者院外尿路护理体会 赵凤艳1 齐海燕2 赵连峰3 （1山东省临沂市太平街道卫生院 276029） （2临沂市肿瘤医院头颈外科 276000；3临沂市人民医院脊柱外科 276000） 【中图分类号】R473 【文献标识码】B【文章编号】1672-5085（2012）47-0244-02 【摘要】 目的 探讨脊髓损伤出院后病人自我排尿训练的方法以及对泌尿系感染的影响。方法 对出院的47例脊髓损伤病人的排尿进行指导和训练，出院2周后拔除导尿管，行间断排尿训练，重建膀胱反射。结果　有32例成功重建排尿功能，其中有12例发生泌尿系感染；有15例未能重建排尿功能，其中发生泌尿系感染的有9例。排尿重建功能成功的患者其泌尿系感染的发生率明显低于重建未成功者，Plt;0.05，差异具有统计学意义。结论　脊髓损伤患者出院后，可以通过有针对性的训练成功摆脱导尿管，建立膀胱反射，这种做法能有效降低泌尿系感染的发生率。 【关键词】脊髓损伤 间歇导尿 重建排尿反射 泌尿系感染 Clinical Experience of Urinary Care of 47 patients with Complete Spinal Cord Injury(SCI) ZHAO Fengyan,(Taiping Hospital of Hedong district of Linyi City in Shandong Province, 276029) 【Abstract】Objective　To evaluate the impact of methods of urinary management on reconstructing urinary function and urinary tract infection(UTI) in patients with spinal cord injury (SCI) in lateral period. Methods　Forty-seven patients with complete spinal cord injury out of spinal surgery unit to rehabilitation training first were trained to reconstruct urinary function. pulled out catheter two weeks after outhospital, patients were directed to intermittent catheterization and intermittent reconstructing urinary reflex. Results 12 patients in 32 patients getting successful urinary function occurred urinary tract infection and 9 patients in 15 patients default to reconstructing urinary reflex also caught by the infection. The successful patients were significantly lower in urinary infection than the default ones(Plt;0.05). Conclusion The discharged patients in SCI should begin intermittent catheterization and reconstruct urinary reflex function as soon as possible, which will be helpful to prevent urinary tract infection. 【Key words】 Spinal cod injury(SCI) Intermittent catheterization Reconstructing urinary Function Urinary tract infection(UTI) 目前对脊髓完全性损伤患者排尿障碍，导尿仍旧是最常用的处理方式。病人在住院期间的相关处理往往有专业的医护人员进行，故排尿障碍所致泌尿系感染以及反复的泌尿系感染导致肾功能不全的发生率都比较低。但对于出院回家后的病人，尤其是医疗卫生条件不便利的农村患者，尿管长期留置除了增加泌尿系感染的机会外，还会引起泌尿系的结石，严重影响患者及家人生活质量。 本组对2