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陈亚平,杨延砚,周谋望,刘 楠,谷 莉.视觉反馈排尿训练在治疗脊髓损伤后神经源性膀胱中的应用[J].中国康复医学杂志,2008,23(2):117~119
视觉反馈排尿训练在治疗脊髓损伤后神经源性膀胱中的应用    点此下载全文
陈亚平  杨延砚  周谋望  刘 楠  谷 莉
北京大学第三医院康复医学科,100083
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摘要:
      目的:观察视觉反馈排尿训练用于脊髓损伤后神经源性膀胱的疗效。方法:31例脊髓损伤后神经源性膀胱患者,以测压管连通导尿管,使患者可以直视膀胱内压的变化,根据患者排尿障碍的不同进行不同模式的视觉反馈膀胱训练。训练前后记录安全容量、基础膀胱内压、最高膀胱内压、自排尿量、残余尿量、排尿时程等数据。结果:经过2—8周训练,患者的平均最大膀胱内压由30.372±12.957cmH2O增至63.378±19.313cmH2O,尿潴留、无自主排尿者(16例)中有12例可以自主排尿,且残余尿量<100ml,4例目前尚无自主排尿,但可明确感知膀胱充盈;有自主排尿,但残余尿量≥100ml者(14例)中有12例残余尿量降至100ml以下,2例残余尿量仍在150—200ml;有自主排尿,但排尿时程延长的1例患者控制膀胱内压能力有所提高,但排尿时程仍较伤前长。结论:视觉反馈排尿训练用于脊髓损伤后神经源性膀胱患者的膀胱训练,可以有效提高膀胱内压,为膀胱功能的恢复创造了良好条件。
关键词:脊髓损伤  神经源性膀胱  视觉反馈
Effect of bladder training with visual biofeedback on neurogenic bladder following spinal cord injury    Download Fulltext
Rehabilitation Center of 3rd Hospital, Peking University, Beijing, 100083
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Abstract:
      Objective: To observe the effect of bladder training with visual biofeedback on neurogenic bladder(NB) following spinal cord injury. Method: Thirty-one patients who suffered from neurogenic bladder following spinal cord injury were involved in this study. The urethral catheter and an empty tube were connected to let the patients watching the change of intravesical pressure(IP) by themselves. The patient would practice different kinds of bladder training based on different kinds of urinating dysfunction. The safe capacity, basal IP, maximum IP, urinary output, residual urine volume and time course of urination were recorded before and after training. Result: After 2—8 weeks training, the average maximum IP raised from 30.372±12.957cmH2O to 63.378±19.313cmH2O. In 16 patients who showed retention of urine, 12 patients could urinate by themselves and the other 4 patients could feel filling of bladder. As to the 14 patients who can urinate by themselves with the residual urine volume≥100ml, 12 patients′ residual urine volume dropped to below 100ml, 2 patients′ residual urine volume remained 150—200ml. The patient who can urinate by himself with a long time course improved his ability of controlling the IP, but the time course was still longer than normal. Conclusion: The bladder training with visual biofeedback on NB following SCI can improve the IP effectively, which created good condition for the bladder to regain its function.
Keywords:spinal cord injury  neurogenic bladder  visual biofeedback
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