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[神经疾病中泌尿系统症状的流行病学。在一家神经康复中心的前瞻性分析]

[Epidemiology of urological symptoms in neurological disorders. A prospective analysis in a center for neurological rehabilitation].

作者信息

Zellner M

机构信息

Urologische Klinik, Klinikum Passauer Wolf, Thermalbadstrasse 20, Bad Griesbach, Germany.

出版信息

Urologe A. 2008 Jun;47(6):675-84. doi: 10.1007/s00120-008-1669-6.

DOI:10.1007/s00120-008-1669-6
PMID:18437342
Abstract

The frequency of urological symptoms and malfunctions was determined in a representative group of patients in a neurological rehabilitation center in Northern Bavaria. All 225 consecutive inpatients between October 2002 and April 2003 were questioned by an experienced neuro-urologist about relevant urological symptoms. The Barthel index, IPSS, and a simple quality of life score were ascertained in addition. We tried to analyze indication, frequency, and quality of any treatment for previous urological symptoms in the assigning institution. An assessment of the known therapy of urological symptoms in pretreating facilities was documented in 190 patients (84.4%). In 105 cases (55.3%) treatment was appraised as sufficient (including all patients without urological symptoms) and not sufficient in 85 cases (44.7%). At the time of admission into the rehabilitation center no urological symptoms were seen in 78 cases (35.1%); 144 patients (64.9%) presented with relevant urological symptoms. It could be pointed out that patients with urological symptoms without adequate treatment lost quality of life significantly, both at medical and at subjective assessment. Total morbidity of patients with urological symptoms was shown to be worse regarding Barthel index, IPSS, and quality of life assessed by IPSS. By providing continuous neuro-urologically qualified support, deficits due to inadequate pretreatment could be compensated in comparison to the group with appropriate pretreatment. A further optimization of the rehabilitation potential of neurologically ill patients seems possible by an implementation of urological base measures into the neurological treatment routine and improved urological training of neurological treatment teams.

摘要

在巴伐利亚北部一家神经康复中心的一组具有代表性的患者中,确定了泌尿系统症状和功能障碍的发生率。2002年10月至2003年4月期间,连续收治的225名住院患者均由经验丰富的神经泌尿科医生询问相关泌尿系统症状。此外,还确定了巴氏指数、国际前列腺症状评分(IPSS)和一个简单的生活质量评分。我们试图分析转诊机构中既往泌尿系统症状的任何治疗的指征、频率和质量。190例患者(84.4%)记录了对预处理机构中已知的泌尿系统症状治疗方法的评估。105例(55.3%)治疗被评估为充分(包括所有无泌尿系统症状的患者),85例(44.7%)治疗不充分。在进入康复中心时,78例(35.1%)患者未见泌尿系统症状;144例(64.9%)患者出现相关泌尿系统症状。可以指出,泌尿系统症状未得到充分治疗的患者在医学和主观评估方面生活质量均显著下降。在巴氏指数、IPSS以及通过IPSS评估的生活质量方面,有泌尿系统症状患者的总体发病率更高。与预处理适当的组相比,通过提供持续的神经泌尿科专业支持,可以弥补预处理不足导致的缺陷。通过将泌尿系统基础措施纳入神经治疗常规并改善神经治疗团队的泌尿系统培训,似乎有可能进一步优化神经疾病患者的康复潜力。

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