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在缺乏服务的脊髓损伤患者尿路重建后的长期决策遗憾和相关因素
Aidin Abedi1,2,3,4, Luis Morales Ojeda3,5,6,7, Stefania Montero3,5,8
1USC Neurorestoration Center, Keck School of Medicine, University of Southern California, Los Angeles, California.
The Journal of urology
|December 17, 2024
概括
在脊髓损伤患者中,神经性膀的尿路重建显示长期遗憾较低. 频繁的膀灌与遗憾有关,突出了其在神经性膀功能障碍患者中心护理中的重要性.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 神经外科 神经外科
- 重建性手术是一种重建性手术.
背景情况:
- 在脊髓损伤 (SCI) 患者中,耐火性神经性膀功能障碍往往需要尿路重建,以控制失禁,导管困难,并预防上道损伤.
- 经过如此复杂的重建程序后,长期的结果和患者满意度,特别是决策后悔,对于明智的决策至关重要.
研究的目的:
- 为了评估经过尿路重建的SCI患者的长期决策遗憾.
- 在这种患者群体中,在尿路重建后,确定与决策后悔相关的因素.
主要方法:
- 采访了至少10年前进行的尿路重建的SCI患者队列.
- 经过验证的调查评估了肠道生活质量 (QoL),尿路感染 (UTI) 和决策遗憾.
- 神经性膀症状评分被用来评估每日膀管理和症状;图表审查提供了人口统计和损伤数据.
主要成果:
- 52名患者的平均随访时间为21.9年,他们的中位数是决定后悔得分,表明后悔程度低.
- 增加膀灌的频率与更高的决策后悔有显著的关联 (P = .002).
- 手术后悔与肠道 QoL 降低和神经性膀症状得分较高相关,特别是在失禁和后果领域.
结论:
- 使用肠道插入的长期尿路重建是SCI患者耐火性神经性膀的受欢迎和持久的治疗方法.
- 需要定期灌注膀等因素应与患者讨论,以促进共享决策和管理期望.
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