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[332例脑卒中慢性期患者的尿液管理]

[Urinary managements of 332 stroke patients in the chronic phase].

作者信息

Shiomi T, Yasukawa M, Yoshii M, Takahashi S, Yamamoto M, Momose H, Suemori T, Yamada K, Ozono S, Okajima E

机构信息

Department of Urology, Bobath Hospital.

出版信息

Nihon Hinyokika Gakkai Zasshi. 1992 Dec;83(12):2029-36. doi: 10.5980/jpnjurol1989.83.2029.

Abstract

Urinary managements of 332 stroke patients in the chronic phase were performed at Bobath hospital. Cerebrovascular accidents (CVA) were caused by cerebral infarction in 178 (53.6%), intracerebral hemorrhage in 123 (37.1%) and subarachnoid hemorrhage in 31 (9.3%). Voluntary urination appeared in 124 patients before treatment, however in 29 of them occasional incontinence were observed. One hundred forty-three patients used diapers and 64 were controlled by indwelling catheters. The remaining one patient was treated by intermittent catheterization. Sixty-two patients who seemed to have communicative abilities in daily living were assessed with regard to their cerebrovascular dementia by Hasegawa's Dementia Rating Scale. After treatment 235 patients (70.8%) were able to urinate voluntarily, and only 15 of them remained incontinent and could use small pads successfully. TURP was effective for the stroke patients with benign prostatic hypertrophy (BPH) or bladder neck sclerosis (BNS). Fifty-three patients (16.0%) with persistent urinary incontinence were managed by diapers or a system of condom drainage. Thirty-nine patients (11.7%) were kept dry with intermittent catheterization at home, and long-standing use of indwelling catheters were required in the remaining 5 patients (1.5%). These results indicate that the lower level of activity, mobility and mental state tended to prevent the stroke patients from improvement of urinary disorders.

摘要

在Bobath医院对332例慢性期脑卒中患者进行了排尿管理。脑血管意外(CVA)由脑梗死引起的有178例(53.6%),脑出血123例(37.1%),蛛网膜下腔出血31例(9.3%)。治疗前124例患者出现自主排尿,但其中29例偶尔有尿失禁现象。143例患者使用尿布,64例通过留置导尿管控制排尿。其余1例患者采用间歇性导尿治疗。对62例在日常生活中似乎有交流能力的患者,用长谷川痴呆量表评估其脑血管性痴呆情况。治疗后235例患者(70.8%)能够自主排尿,其中只有15例仍有尿失禁,能够成功使用小护垫。经尿道前列腺电切术(TURP)对患有良性前列腺增生(BPH)或膀胱颈硬化(BNS)的脑卒中患者有效。53例(16.0%)持续性尿失禁患者采用尿布或避孕套引流系统处理。39例(11.7%)患者在家中通过间歇性导尿保持干爽,其余5例(1.5%)患者需要长期留置导尿管。这些结果表明,活动水平、移动能力和精神状态较低往往会阻碍脑卒中患者排尿障碍的改善。

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