脊髓損傷患者膀胱管理的影響因素

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ABSTRACT：ObjectiveTo explore the key factors affecting the selection and effectiveness of bladder management modalities in patients with spinal cord injury，so as to provide reference for the optimization of individualized bladder management strategies.MethodsThe clinical and follow-up data of 78 patients with spinal cord injury treated in our hospital during Jan.1，2013 and Dec.31，2022 were retrospectively analyzed.The distribution of bladder management modalities among different grades of injuries was analyzed. Bowker symmetry test was used to evaluate the difference between bladder management modalities at discharge and at the end of follow-up. Multiple linear regression was used to explore the influencing factors of bladder management effects. Plotting Kaplan-Meier survival curves were adopted to calculate the median time of changes in bladder management.ResultsAt discharge，there were 9 cases of self-catheterization，19 cases of intermittent catheterization，22 cases of reflexive voiding，26 cases of long-term catheterization，and 2 cases using urinary collector.At the end of follow-up，there were 15 cases of self-catheterization，8 cases of intermittent catheterization，34 cases of reflexive voiding，14 cases of long-term catheterization，and 7 cases using urinary collector.There was a significant difference between the modalities of bladder management at discharge and at the end of follow-up （χ2=21.43，P=0.018）.Multiple linear regression showed a significant decrease of 8.60 in the total neurogenic bladder symptom score （NBSS） for grade D injuries compared with grade A injuries （P=0.026）.The median time to bladder management change was 7.93 months （95%CI：5.449.44）， with approximately 50% of patients experiencing a change in bladder management within 8 months after discharge.ConclusionThe modalities of bladder management changed significantly after discharge.The grade of injury was a key factor affecting the effectiveness of bladder management.Higher grade was associated with worse effectiveness of bladder management.

摘要：目的探討影響脊髓損傷患者膀胱管理方式選擇及效果的關(guān)鍵因素，為優(yōu)化個體化膀胱管理策略提供參考。（剩余9890字）