膀胱括约肌的功能训练（Functional training of the bladder
sphincter）
Bladder control training is a rehabilitative treatment for patients with upper motor neuron damage syndrome complicated with bladder dysfunction. [indications]
Patients with upper motor neuron damage syndrome complicated with bladder control disorders, including spinal cord injury, stroke, brain trauma, etc.. The patient can perform it independently when it is functioning well, otherwi it can be carried out by the chaperone. But the patient must be able to cooperate actively.
[contraindication]
1, confusion, or unable to cooperate with treatment.
2, bladder or urinary tract rious infection.
3 、 vere prostatic hypertrophy or tumor.属相守护神
[instruments]
公益文案
No special equipment is needed.
[operating procedures]
1, bladder sphincter control force training commonly ud pelvic floor muscle exerci method: active contraction of the pubis coccyx muscle (anal sphincter), each contraction
continued 10 s, repeated 10 times, 3~5 times daily.
2 、 micturition reflex training found or induced "trigger point", through the reflex mechanism to promote the contraction of the urinary muscle, so as to take the initiative to urinate. The common micturition reflex "trigger point" is to light the pubic region, pull pubic hair, rub the inside of the thigh, and squeeze the penis, glans and so on. Listening to the sound of water, hot drinks, warm water bath and so on are auxiliary measures. Percussion should be light and fast, avoiding heavy percussion. Heavy percussion can cau dysfunction of bladder and urethra. Tap frequency 50~100 times /min, the number of times 100~500 times. Higher spinal cord injury usually restores reflex voiding.
3, compensatory urination training, through manipulation and incread abdominal pressure and other ways to promote urination, mainly including:
好句二年级
西南交大分数线(1) Valsalva method: the patient takes the at, relaxes the abdomen, the body leans forward, holds the breath, 10~12 s,
Force the abdominal pressure to the bladder, rectum and pelvic floor, flexion hip and knee joints, so that the thigh clo to the abdomen, prevent abdominal bulge, increa abdominal pressure.
(2) Crede technique: both hands are placed at the iliac crest, and the rest of the fingers are placed at the top of the bladder (below the umbilicus), gradually exerting force to the lower part of the bladder. Pressure should be slow and gentle, avoid
using violence and direct pressure on the pubis. Excessive bladder pressure can cau bladder damage and reflux of urine to the kidneys.
4, water intake and output control training, establish a regular, quantitative drinking water and regular urination system. This is the basic measure of bladder training. Becau the physiological capacity of the bladder is about 400 ml, so the amount of water 400~450 ml is appropriate, so that after urination bladder capacity of about 400 ml. The interval between drinking and urination is usually 1~2 h, which is related to body position and temperature. When the lying position and the temperature were low, the interval of urination was shortened, while the other was prolonged. The da
ily total urine volume 800~1000 ml is appropriate.
5, clean catheterization (intermittent catheterization), cleaning catheterization is the end of the initial steps to retain catheterization, so that the bladder training can be effectively carried out. At the same time, when the above method fails to make the bladder empty, the method of cleaning urethral catheterization can intermittently evacuation residual urine and reduce the chance of bladder infection. Specific methods refer to "clean catheterization technique"".
[matters needing attention]
1, when training begins, we must strengthen the monitoring of bladder residual urine volume, so as to avoid urinary retention.
2 avoid excessive bladder filling or excessive pressure, resulting in urine reflux to the kidneys.
3, bladder reflex needs a certain amount of time to accumulate, so pay attention to step by step when training.
4. When combined with spasm, the bladder emptying activity is cloly related to the ont of spasm. It is necessary to pay attention to the relationship between urination and the relea of muscl
e spasm.
腊梅花期
左宗棠传Rectal control training
Rectal control disorder is a common functional problem of upper motor neuron and one of the biggest problems for patients. The rectum control training mainly aims at two aspects of constipation and fecal incontinence.
[indications]
Patients with upper motor neuron damage syndrome associated with rectal control disorders, including spinal cord injury, stroke, brain trauma, etc.. The patient has good hand function and can be done independently, otherwi the caregiver can perform it. But the patient must be able to cooperate actively.
[contraindication]
党的什么是党的根本性建设1, the nerve is unclear, or can not cooperate with the treatment.
2, anal and rectum local skin damage, or rious infection.
文公尺3, anal and rectal tumors.
[instruments]
Equipment is not needed.
[operating procedures]
The main measures include rehabilitation constipation anal distraction technique (relieve muscle spasm, anus) diet control, nerve block technique, laxative, lubricant, manual therapy, exerci therapy. The main rehabilitation measures for fecal incontinence include pelvic floor muscle training, intestinal convergence drugs, intestinal motility control drugs, and intestinal inflammation control. Operation techniques include:
Anal stretch technique index or middle finger fingertip, grea, slowly inrted into the anus, the rectal wall to the anus side continuously and slowly pull, can effectively relieve the spasm of anal sphincter, while expanding the rectal cavity, induced intestinal reflex, promote the fecal excretion.
The energy consumption of defecation during sitting, defecation and sitting is 3.6 metabolic equivalent, while lying position is 4 metabolic equivalent. Sitting stool is helpful to reduce defecation
resistance, improve patient lf-esteem, reduce nursing workload and reduce heart burden.
