| 常 鸣,孙秀彬,岳寿伟,张 杨.影响脊髓损伤患者排尿功能的多因素分析[J].中国康复医学杂志,2021,(3):310~314 |
| 影响脊髓损伤患者排尿功能的多因素分析 点此下载全文 |
| 常 鸣 孙秀彬 岳寿伟 张 杨 |
| 山东大学齐鲁医院康复科，山东省济南市，250012 |
| 基金项目：山东省重点研发计划项目（2017G006014） |
| DOI：10.3969/j.issn.1001-1242.2021.03.010 |
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| 摘要： |
| 摘要
目的：分析影响脊髓损伤患者排尿的因素，构建其Logistic预警模型。
方法：2017年1月—2019年6月在山东大学齐鲁医院康复中心住院的脊髓损伤患者，采用简易膀胱尿压测定评定系统测量膀胱安全容量、初始尿意膀胱内压力值、膀胱内最终压力值等指标，利用Logistic回归分析筛选排尿的影响因素。
结果：骶以上损伤者，有排尿的患者最终膀胱压力值明显高于无排尿的患者（P<0.05），而膀胱安全容量明显低于无排尿的患者（P<0.05）。同时，病程也明显较无排尿的患者更长（P<0.05）。骶以下损伤者，各指标无明显显著性意义（P>0.05）。单因素 Logistic 回归分析筛选出年龄、初始尿意膀胱内压力值、膀胱内最终压力值、膀胱安全容量和病程为排尿相关因素。多因素Logistic逐步回归分析显示，膀胱内最终压力值和病程为有显著性意义的影响因素。膀胱最终压力值高的患者其排尿的可能性是膀胱压力低患者的8.745倍（P<0.05），而病程越长，患者排尿的可能性越大（P<0.05）。利用上述危险因素所构建 Logistic 预警模型的接受者工作特征（receiver operator characteristic curve，ROC）曲线下面积为0.787，假设检验结果为z=5.787。
结论：脊髓损伤后排尿功能的相关因素较多，应综合考虑各种因素，进行综合性干预和治疗，尽快建立平衡膀胱，提高患者的生活质量。 |
| 关键词：脊髓损伤 排尿功能 简易膀胱尿压测定 影响因素 预警模型 |
| Multiple factor analysis for urination function after spinal cord injury Download Fulltext |
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| Department of Physical Medicine & Rehabilitation, Qilu Hospital, Shandong University, Jinan, Shandong, 250012 |
| Fund Project: |
| Abstract: |
| Abstract
Objective: To study the influence factors of urination function after spinal cord injury and establish the logistic early warning model.
Method: From January 2017 to June 2019, data of 71 spinal cord injury patients with neurogenic bladder from the rehabilitation center of Qilu Hospital, Shandong University were collected. Bladder urinary pressure evaluation system was used to evaluate the bladder function. The Logistic regression was used to identify the influence factors.
Result: For patients with injury above the sacral level, the final bladder pressure value of patients able to urinate was significantly higher than that of patients without urination (P<0.05), and the safety bladder capacity was significantly lower than that of the patients without urination (P<0.05). Meanwhile, the course of disease was also significantly longer than that of patients without urination (P<0.05). However, there were not statistically significant in the patients with injury below the sacral level (P>0.05). The factors such as age, first desire to void pressure, safety bladder capacity, the final bladder pressure and the course of disease were defined as the urination related factors by single factor Logistic regression analysis. The final bladder pressure and the course of disease were confirmed to be significant influence factors with urination function by multiple factors Logistic stepwise regression analysis. The patients with higher final bladder pressure and the longer course of disease had more possibilities to recover urination (P<0.05). The area under receiver operator characteristic curve of early warning model was 0.787 and the hypothesis test results was z=5.787.
Conclusion: The biological factors of urination function after spinal cord injury is complex. Thus, comprehensive interventions and treatments should be taken into account to establish a balanced bladder as soon as possible and improve the quality of life of patients. |
| Keywords:spinal cord injury urinary function bladder urinary pressure evaluation system influence factors warning model |
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