Son Seok Beom, Chung Seong Yun, Kang Seok, Yoon Joon Shik
Department of Physical Medicine and Rehabilitation, Korea University Guro Hospital, Seoul, Korea.
Ann Rehabil Med. 2017 Apr;41(2):204-210. doi: 10.5535/arm.2017.41.2.204. Epub 2017 Apr 27.
To investigate the relationship between urinary retention and short-term functional recovery in subacute stage after stroke.
The medical records of 94 patients admitted to the rehabilitation unit of Korea University Guro Hospital were reviewed retrospectively. The postvoid residual urine (PVR) was measured at least once a day using a bladder scan, and urinary retention (UR) was defined when the daily PVR volume consistently checked more than 100 mL. Clinical data and functional outcomes of patients in the rehabilitation ward were collected. Functional outcomes were measured using the Mini-Mental State Examination (MMSE), Berg Balance Scale (BBS), Functional Ambulation Category (FAC) level, Fugl-Meyer Assessment (FMA), and Modified Barthel Index (MBI) at admission (or transfer) and discharge. The data of patients with and without urinary retention were compared and analyzed.
Of the 94 participants, 25 patients were classified to the UR group and 69 were classified to the non-UR group. At the initial stage of rehabilitation, the scores of MMSE, BBS, FAC, MBI were significantly worse in the UR group (p<0.05). Both groups showed significant improvements of all functional outcomes after rehabilitation (p<0.05). The non-UR group showed more prominent recovery of BBS, FAC, MBI scores (p<0.05).
Urinary retention in post-stroke patients is significantly related to the poor functional status at initial stage of rehabilitation, and also to poor recovery after rehabilitation.
探讨脑卒中亚急性期尿潴留与短期功能恢复之间的关系。
回顾性分析韩国大学古罗医院康复科收治的94例患者的病历。使用膀胱扫描仪每天至少测量一次排尿后残余尿量(PVR),当每日PVR量持续超过100 mL时定义为尿潴留(UR)。收集康复病房患者的临床资料和功能结局。在入院(或转科)及出院时,使用简易精神状态检查表(MMSE)、伯格平衡量表(BBS)、功能性步行分类(FAC)水平、Fugl-Meyer评估(FMA)和改良Barthel指数(MBI)测量功能结局。对有尿潴留和无尿潴留患者的数据进行比较和分析。
94名参与者中,25例患者被归类为尿潴留组,69例被归类为非尿潴留组。在康复初期,尿潴留组的MMSE、BBS、FAC、MBI评分明显更差(p<0.05)。两组在康复后所有功能结局均有显著改善(p<0.05)。非尿潴留组的BBS、FAC、MBI评分恢复更为显著(p<0.05)。
脑卒中后患者的尿潴留与康复初期功能状态不佳显著相关,也与康复后恢复不良相关。