Abstract: Objective　To investigate the effect of intermittent clean catheterization combined with comprehensive rehabilitation training for paraplegic patients with spinal cord injury (SCI). Methods　Using random number table method, 80 paraplegic patients with SCI admitted to Zhumadian Hospital of Traditional Chinese Medicine from January 2019 to January 2022 were randomly divided into a control group and an observation group, with 40 cases in each group. The control group took routine catheterization and intervention, and the observation group took intermittent clean catheterization and comprehensive rehabilitation training. Before and after the intervention, the bladder function, urodynamic indicators, and quality of life of the two groups were evaluated, and the prognosis of the two groups was evaluated. t and χ² tests were applied. Results　After the intervention, the residual urine volume decreased in the two groups, and was lower in the observation group than in the control group (t=7.324, P<0.001); the bladder volume and maximum voiding volume increased in both groups, and were higher in the observation group than in the control group, with statistical differences (t=5.789 and 13.905; both P<0.001). After the intervention, the levels of detrusor pressure (Pdet) and bladder pressure (Pves) decreased in both groups, and were lower in the observation group than in the control group, with statistical differences (t=4.138 and 5.611; both P<0.001); the bladder compliance (BC) increased in both groups, and was higher in the observation group than in the control group, with statistical a difference (t=3.330, P=0.001). After the intervention, the scores of the International Advisory Council on Urinary Incontinence Questionnaire - Overactive Bladder Sub-Questionnaire (ICIQ-OAB) decreased in both groups, and were lower in the observation group than in the control group, with statistical differences (all P<0.001). The incidence of urinary tract infection in the observation group was lower than that in the control group [5.00% (2/40) vs. 20.00% (8/40)], with a statistical difference (χ²=4.114, P=0.043). Conclusion　Intermittent clean catheterization combined with comprehensive rehabilitation training for paraplegic patients with SCI can effectively improve their bladder function, urodynamic indicators, quality of life, and prognosis.

Key words: Spinal cord injury, Paraplegia, Intermittent clean catheterization, Comprehensive rehabilitation training, Bladder function, Prognosis

摘要： 目的　探讨脊髓损伤（SCI）截瘫患者采用间歇清洁导尿联合综合康复训练的效果。方法　采用随机数字表法将2019年1月至2022年1月驻马店市中医院收治的SCI截瘫患者80例分为两组，各40例，对照组采用常规导尿联合常规干预，观察组采用间歇清洁导尿联合综合康复训练。干预前及干预后评估两组膀胱功能、尿动力学指标及生活质量，评估两组预后情况。统计学方法采用t检验、χ²检验。结果　两组干预后残余尿量均较干预前减少，且观察组少于对照组（t=7.324，P<0.001），两组膀胱容量、最大排尿量均较干预前增多，且观察组多于对照组，差异均有统计学意义（t=5.789、13.905，均P<0.001）；两组干预后逼尿肌压力（Pdet）、膀胱压（Pves）水平均较干预前降低，且观察组低于对照组（t=4.138、5.611，均P<0.001），两组膀胱顺应性（BC）水平均较干预前升高，且观察组高于对照组，差异有统计学意义（t=3.330，P=0.001）；两组干预后国际尿失禁咨询委员会问卷-膀胱过度活动分问卷（ICIQ-OAB）评分各项目评分及总分均较干预前降低，且观察组低于对照组，差异均有统计学意义（均P<0.001）；观察组发生泌尿系感染率为5.00%（2/40），对照组发生泌尿系感染率为20.00%（8/40），观察组泌尿系感染发生率低于对照组，差异有统计学意义（χ²=4.114，P=0.043）。结论　SCI截瘫患者采用间歇清洁导尿联合综合康复训练可有效改善膀胱功能及尿动力学指标，提高生活质量，改善预后。

关键词: 脊髓损伤, 截瘫, 间歇清洁导尿, 综合康复训练, 膀胱功能, 预后