Abstract:

Objective　To construct an evidence-based neurogenic bladder management protocol and evaluate its application effect. Methods　Patients with neurogenic bladder from Urinary Surgery, Guangzhou First People's Hospital were selected by convenience sampling. According to the date of first visit, 51 patients from July 2022 to January 2023 were recruited to the control group, who were given routine management, including 26 males and 25 females, with an age of (56.12±9.20) years old; 51 patients from February 2023 to July 2023 were recruited to the observation group, who were given evidence-based neurogenic bladder management, including 23 males and 28 females, with an age of (55.80±7.02) years old. The psychological status [Self-rating Anxiety Scale (SAS) score and Self-rating Depression Scale (SDS) score] and bladder function recovery (bladder capacity, maximum urine output, and residual urine volume) of the two groups were compared before and after management. Independent sample t test was used for the measurement data and χ² test was used for the count data. Results　Before management, there were no statistically significant differences in the score of SAS or SDS between the two groups (P=0.694 and 0.275). After management, the SAS score of the observation group was lower than that of the control group [(19.89±3.51) points vs. (26.20±3.38) points] (P<0.001), and the SDS score of the observation group was lower than that of the control group [(34.86±2.42) points vs. (47.23±4.59) points] (P<0.001). Before management, there were no statistically significant differences in the bladder function indexes between the two groups (all P>0.05). After management, the bladder capacity of the observation group was higher than that of the control group [(371.66±62.67) ml vs. (344.51±60.35) ml] (P<0.05), the maximum urine output of the observation group was higher than that of the control group [(243.37±56.79) ml vs. (197.48±49.90) ml] (P<0.001), and the residual urine volume of the observation group was lower than that of the control group [(89.69±17.59) ml vs. (99.55±20.96) ml] (P<0.05). Conclusion　Evidence-based neurogenic bladder management can improve the negative emotions and bladder function in patients with neurogenic bladder.

Key words:

Neurogenic bladder, Evidence-based concept, Management program, Construction, Clinical application

摘要：

目的　构建基于循证的神经源性膀胱管理方案并探讨其应用效果。方法　采用便利抽样法，选取广州市第一人民医院泌尿外科神经源性膀胱患者作为研究对象，根据患者首次就诊时间，将2022年7月至2023年1月收治的51例患者纳入对照组，实施常规管理，其中男性26例，女性25例，年龄（56.12±9.20）岁；将2023年2月至2023年7月收治的51例患者纳入观察组，实施基于循证的神经源性膀胱管理，其中男性23例，女性28例，年龄（55.80±7.02）岁。比较两组患者管理前后的心理状态［焦虑自评量表（SAS）评分、抑郁自评量表（SDS）评分］、膀胱功能恢复情况（膀胱容量、最大排尿量、残余尿量）。计量资料采用独立样本t检验，计数资料采用χ²检验。结果　管理前，两组患者SAS、SDS评分比较，差异均无统计学意义（P=0.694、0.275）；管理后，观察组SAS评分低于对照组［（19.89±3.51）分比（26.20±3.38）分］（P<0.001），观察组SDS评分低于对照组［（34.86±2.42）分比（47.23±4.59）分］（P<0.001）。管理前，两组患者膀胱功能指标比较，差异均无统计学意义（均P>0.05）；管理后，观察组膀胱容量高于对照组［（371.66±62.67）ml比（344.51±60.35）ml］（P<0.05），观察组最大排尿量高于对照组［（243.37±56.79）ml比（197.48±49.90）ml］（P<0.001），观察组残余尿量低于对照组［（89.69±17.59）ml比（99.55±20.96）ml］（P<0.05）。结论　基于循证的神经源性膀胱管理方案能够改善神经源性膀胱患者负面情绪及膀胱功能。

关键词:

神经源性膀胱, 循证理念, 管理方案, 构建, 临床应用