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超声辅助诱导排尿护理用于管理养老院中的尿失禁:一项随机临床试验。

Ultrasound-assisted prompted voiding care for managing urinary incontinence in nursing homes: A randomized clinical trial.

机构信息

Department of Urology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.

Department of Urology, Center Hospital of the National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan.

出版信息

Neurourol Urodyn. 2019 Feb;38(2):757-763. doi: 10.1002/nau.23913. Epub 2019 Jan 8.

Abstract

AIMS

To determine whether ultrasound-assisted prompted voiding (USAPV) care is more efficacious than conventional prompted voiding (CPV) care for managing urinary incontinence in nursing homes.

METHODS

Thirteen participating nursing homes in Japan were randomized to CPV (n = 7) or USAPV care group (n = 6). Residents of the allocated nursing homes received CPV (n = 35) or USAPV (n = 45) care for 8 weeks. In the CPV group, caregivers asked the elderly every 2-3 h whether they had a desire to void and prompted them to void when the response was yes. In the USAPV group, caregivers regularly monitored bladder urine volume by an ultrasound device and prompted them to void when the volume reached close to the individually optimized bladder capacity. Frequency-volume chart was recorded at the baseline and after the 8-week intervention to measure the daytime urine loss.

RESULTS

The change in daytime urine loss was statistically greater in the USAPV (median, -80.0 g) than in the CPV (median, -9.0 g; P = .018) group. The proportion of elderly individuals whose daytime urine loss decreased by >25% was 51% and 26% in the USAPV and CPV group, respectively (P = .020). Quality-of-life measures of elderly participants showed no significant changes in both groups. The care burden scale score of caregivers was unchanged in the USAPV group (P = .59) but significantly worsened in the CPV group (P = .010) after the intervention.

CONCLUSIONS

USAPV is efficacious and feasible for managing urinary incontinence in nursing homes.

摘要

目的

确定超声辅助导尿(USAPV)护理是否比常规导尿(CPV)护理更能有效管理养老院中的尿失禁。

方法

日本的 13 家参与养老院被随机分配到 CPV(n=7)或 USAPV 护理组(n=6)。分配到指定养老院的居民接受 CPV(n=35)或 USAPV(n=45)护理 8 周。在 CPV 组,护理人员每 2-3 小时询问老年人是否有排尿的欲望,并在回答是时提示他们排尿。在 USAPV 组,护理人员通过超声设备定期监测膀胱尿量,并在接近个人优化的膀胱容量时提示他们排尿。在基线和 8 周干预后记录频率-容量图表,以测量白天的尿失禁量。

结果

USAPV(中位数,-80.0g)组白天尿失禁量的变化在统计学上明显大于 CPV 组(中位数,-9.0g;P=0.018)。白天尿失禁量减少>25%的老年人比例分别为 51%和 26%,USAPV 和 CPV 组(P=0.020)。两组老年人的生活质量指标均无明显变化。USAPV 组护理人员的护理负担评分无变化(P=0.59),而 CPV 组在干预后显著恶化(P=0.010)。

结论

USAPV 对管理养老院中的尿失禁是有效和可行的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7eef/6849834/65385609c03d/NAU-38-757-g001.jpg

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