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目的:探讨膀胱功能重建护理在脊髓损伤(SCI)后膀胱造瘘患者中的应用方法与临床效果。方法:按医嘱在实施康复治疗的基础上,对患者进行综合护理评估,结合膀胱造瘘口护理,加强患者、家属和陪护人员的康复专科宣教与督导;在B超监测下拔除膀胱造瘘口的导尿管,随后进行为期16周的膀胱功能重建护理;采取自身对照方法,动态观察患者在尿常规、中段尿培养,膀胱容量、残余尿量和自扣尿量的前后变化。结果:经B超证实在拔除耻骨联合上膀胱造瘘口的尿管后7 d即创口愈合;经过16周的膀胱功能重建护理后,患者的尿常规和中段尿培养均恢复正常,残余尿量由430~600 m L/次逐渐减少至100~20 m L/次、自扣尿量由0 m L/次提高到220~300 m L/次;实现SCI患者耻骨联合上膀胱造瘘口的尿管拔除后的放射性排尿。结论:膀胱功能重建护理在SCI后膀胱造瘘患者中的应用取得了较好的临床效果。
Objective: To investigate the application and clinical efficacy of bladder functional reconstruction in patients with cystostomy after spinal cord injury (SCI). Methods: According to the doctor’s advice on the basis of rehabilitation treatment, comprehensive nursing assessment of patients, combined with bladder stoma care, to strengthen the rehabilitation of patients, their families and caretakers specialist education and supervision; removal of bladder stoma in B-monitoring Of the catheter, followed by a 16-week reconstruction of bladder function; using self-control method, dynamic observation of patients in the urine routine, the middle of urine culture, bladder capacity, residual urine volume and urine volume before and after the change. Results: The wounds were healed 7 days after the removal of the urethra of the pubic symphysis bladder stoma by B-mode ultrasound. After 16 weeks of bladder functional reconstruction, the urinary routine and middle urinary culture of the patients returned to normal and the residual urine volume From 430 to 600 m L / time to 100 to 20 m L / time, urine volume from 0 m L / time to 220 ~ 300 m L / time; SCI patients with pubic symphysis on the stoma Radiological urination after removal of the catheter. Conclusion: The application of bladder functional reconstruction nursing in patients with cystostomy after SCI has achieved good clinical effect.