Method Of Individual Safe Urine Volume For Bladder Function Rehabilitation In Spinal Cord Injury Patients

ObjectiveTo explore the role of the intermittent catheterization guided by the individual safe urine volume in spinal cord injury patients to reduce the urological complications, so as to improve the quality of life of patients.MethodsWe firstly analyzed the characteristics and epidemiological risk factors of urinary tract infections (UTIs) among 503 spinal cord injury patients at the stage of rehabilitation. Secondly,60 spinal cord injury patients were conducted combined spinal rehabilitation of acupuncture, electrical stimulation and intermittent catheterization.60 patients were randomized divided into 2 groups.All patients were underwent urodynamic or video-urodynamic studies. Small bladder volume were extended to 300ml (bladder pressure<40cmH2O) The controlled group perform regularly intermittent catheterization according to residual urine, meanwhile, the experiment group perform intermittent catheterization guided by individual safe urine volume. We examine the outcomes of intermittent catheterization guiede by different index, observing the UTIs and variation of bladder rehabilitation parameters.Results1.503 cases were adopted in our study with a mean age of 37.7years (s.d=13.4 year)-81.13% of them being male (M/F=4.29/1).Urinary tract infections incidence rate accounted for 60.6%.Multivariate logistic regression analysis showed that, damage segement (OR=1.283, CI:1.006-1.637, P=0.045), damage level (OR=1.178, CI:1.001-1.386, P= 0.049), micturition way (OR=1.395, CI:1.256-1.549, P=0.000),duration(OR=1.675, CI:1.391-2.016, P=0.000)were the risk factors of spinal cord injury patients with urinary tract infections.2.Sixty patients were adopted in our study.For post voiding residual, the experiment group decreased from 299.20(± 166.49) ml to 155.90(± 161.59) ml vs the controlled group decreased from 227.50(±148.22) ml to 103.83(±131.24) ml(P<0.05). For the first micturition reflex time, the experiment group were 3.89(±2.07)d vs the controlled group were 4.68(±4.27)d(P<0.05). For the bladder reconstruction time, the experiment group were 31.22(±18.86)d vs the controlled group were 49.57(±32.79)d(P<0.05). Patients with UTIs had significantly difference (1.34 vs 1.94, P<0.01)Conclusions1. Urinary tract infection is the highest complication among spinal cord injury patients.Damage level, damage segement, duration and micturition way are the risk factors influenced the urinary tract infection to spinal cord injury patients.2. By the method of individual safe urine volume to intermittent catheterization can effectively reduce the first micturition reflex time, reduce the bladder reconstruction time, reduce residual urine, decrease the incidence of urinary tract infection, which can improve the quality of life of spinal cord injury patients.