徐月红等

[摘要] 目的 观察针灸配合间隙性清洁导尿在神经源性膀胱中的疗效。 方法 将46例患者随机分成实验组23例和对照组23例，实验组应用针灸配合间隙清洁导尿法，对照组则应用间隙清洁导尿法，5个月后比较两组患者排尿功能重建（残余尿量）及实验室指标（菌尿发生率）。 结果 实验组17例排尿功能重建（残余尿量明显减少），对照组7例；实验组菌尿发生3例，对照组11例。两组比较差异有统计学意义（P<0.05）。 结论 针灸结合间隙性导尿更能维持膀胱的正常生理状态，减少残余尿量，减少泌尿系细菌感染机会。

[关键词] 针灸；间隙性清洁导尿；神经源性膀胱

[中图分类号] R246.6 [文献标识码] B [文章编号] 1673-9701（2014）29-0149-03

The effect of acupuncture combined with clean intermittent catheterization used for neurogenic bladder

XU Yuehong1 XU Yueyuan2 XU Yuemei3 ZHENG Yaochu1 HU Aimei2 YU Cuiping1 HUANG Wenjuan1 HONG Aixiu1 QIU Weifang1

1.Department of Nursing， the People`s Hospital of Yingtan City in Jiangxi Province， Yingtan 335000， China；2.Department of Rehabilitation，the First Hospitao of Nanchang City， Nanchang 330000， China；3.Department of Neurosurgery，the First Affiliated Hospital of Nanchang University， Nanchang 330006， China

[Abstract] Objective To study the effect of acupuncture combined with clean intermittent catheterization in the treatment of neurogenic bladder. Methods A total of 46 patients were randomly divided into test and control groups. There were 23 patients in the each group. The clean intermittent catheterization only used in the control group. However integrated acupuncture and clean intermittent catheterization were used in the test group. Final the residual urine volume and the incidence of bacteriuria were researched after 5 months. Results There were 17 cases restored the micturating function in the test group， however only 7 cases in the control group. There were 3 cases suffered bacteriuria in the test group， but there were 11 cases suffered bacteriuria in the control group. The difference between the two groups was statistically significantly（P<0.05）. Conclusion Combined acupuncture with clean intermittent catheterization can efficiently maintain the normal function of bladder， decrease the residual urine volume， and reduce the incidence of bacteriuria.

[Key words] Acupuncture； Clean intermittent catheterization； Neurogenic bladder

神经源性膀胱是指控制排尿功能的中枢神经或周围神经受到损害而引起膀胱尿道功能障碍，主要产生复杂的排尿症状，排尿不畅或尿潴留是其中最常见的症状之一[1]，如果处理不当会继发感染、结石，肾脏变形，严重可造成肾功能衰竭，甚至死亡[2]。以前留置尿管是主要解决措施。翁媛英等报道[3]导尿管相关性感染占院内感染的40%。留置导尿<2 d、3～7 d、8～13 d、>14 d等不同时段尿路感染的发生率为6.76%、27.46%、50.98%和100%[4]；袁三英等报道[5]间隙导尿比留置导尿菌尿发生率降低，以上文献报道中均提出留置导尿的危害之处。故我们采用针灸结合间隙性清洁导尿在脊髓损伤（spinal cord injury，SCI）患者中的应用，通过观察排尿功能建立（残余尿量减少）及菌尿发生率疗效较好。现报道如下。

1 资料与方法

1.1 一般资料

选择2008年8月～2013年2月于我院康复科、骨科住院的SCI患者46例，将其分为实验组与对照组各23例，其中男37例，女9例，平均年龄（43±2.5）岁；颈髓损伤6例，胸髓损伤12例，腰骶髓损伤28例；……