王丹　况红梅　万琴　连佳　徐仁伵

【摘要】 目的：探討气囊减压联合持续牵引法在重症脑卒中患者留置尿管漏尿中的应用效果及安全性。方法：选取2017年1-12月本科室留置尿管并发生漏尿的患者90例，根据随机数字表法将其分为A组（采用间断牵引法）、B组（采用持续牵引法）、C组（采用持续牵引联合气囊减压法），各30例。比较三组预防漏尿的效果、并发症发生情况以及膀胱内残余尿量情况。结果：三组预防漏尿的总有效率比较差异有统计学意义（P<0.05），且C组总有效率高于A组（P<0.05）;三组膀胱内残余尿量比较差异有统计学意义（P<0.05），且C组均少于A、B组（P<0.05）;但三组并发症发生率比较差异无统计学意义（P>0.05）。结论：气囊减压联合持续牵引法，注水量10～12 mL、牵引重量100 g能安全地、有效地解决漏尿问题。

【关键词】 气囊减压; 持续牵引; 留置尿管; 漏尿

Application of Balloon Decompression Combined with Continuous Traction in Indwelling Urinary Catheter Leakage in Patients with Severe Stroke/WANG Dan，KUANG Hongmei，WAN Qin，et al.//Medical Innovation of China，2019，16（06）：-147

【Abstract】 Objective：To investigate the effect and safety of balloon decompression combined with continuous traction in treatment of urinary leakage caused by indwelling catheter in patients with severe stroke.Method：A total of 90 patients with urinary leakage after indwelling catheter in our department from January to December 2017 were selected.According to the random number table method，they were divided into A group（intermittent traction），B group（continuous traction），and C group（continuous traction combined with balloon decompression），30 cases in each group.The effect of preventing urinary leakage，complications and residual urine volume in bladder in three groups were compared.Result：The total effective rate of preventing urinary leakage among three groups was compared，the difference was statistically significant（P<0.05），and the total effective rate of C group was higher than that of A group（P<0.05）.The residual urine volume in three groups of bladder was compared，the difference was statistically significant（P<0.05），and C group were less than those of A group and B group（P<0.05）.The complications among three groups was compared，the difference was not statistically significant（P>0.05）.Conclusion：Balloon decompression combined with continuous traction can safely and effectively solve the problem of urinary leakage with water injection of 10-12 mL and traction weight of 100 g.

【Key words】 Balloon decompression; Continuous traction; Indwelling catheter; Leakage of urine

First-authors address：First Affiliated Hospital of Nanchang University，Nanchang 330006，China

doi：10.3969/j.issn.1674-4985.2019.06.039

脑卒中是一种发病率、病死率及致残率均较高的疾病，给个人、家庭以及社会带来了沉重的负担[1-3]。重症脑卒中患者由于疾病原因造成意识丧失经常出现排尿功能紊乱，发生尿潴留或尿失禁等，有研究显示，脑卒中患者有32%～79%在住院期间可能会发生尿失禁[4-6]，约42.5%的患者将出现不同程度的会阴部皮肤损害，临床上通常给予留置尿管。而脑卒中患者大多数为老年人，老年人多由于尿道口萎缩、尿道括约肌收缩力差，盆底肌松弛而造成漏尿[7-9]，同时，重症脑卒中患者常大剂量使用脱水剂，应用过程中由于尿量迅速增加，尿失禁患者发生漏尿的概率增加[10-11]，从而使尿道口周围皮肤长期处于潮湿环境以及尿液的刺激中，继而易导致尿路感染、失禁性皮炎、压疮等并发症[9，11]，不仅影响患者的恢复，还影响尿量的正确统计，延误治疗，亦加大了护理工作的难度，耗费护理资源，增加患者家庭经济负担。……