目的 探讨集束化康复护理联合膀胱功能训练在脊髓损伤神经源性膀胱患者中的应用效果。方法 将收治的脊髓损伤神经源性膀胱患者分为对照组（常规康复护理）和观察组（集束化康复护理+膀胱训练）,每组各72例,两组患者在性别比、年龄、美国脊髓损伤协会（ASIA）分级构成等基线资料上的差异均无统计学意义（P>0.05）。对比经不同护理方案干预4周后,两组患者心理状态[焦虑自评量表（SAS）评分/抑郁自评量表（SDS）评分]、生活质量[健康状况调查问卷（SF-36评分）]变化,以及排尿功能及尿路感染发生率的差异。结果 康复护理干预4周后,观察组SAS、SDS评分均低于对照组,SF-36评分则高于对照组,差异均有统计学意义（P<0.05）;观察组逼尿肌压、膀胱残余尿量均低于对照组,最大膀胱容量则高于对照组,差异均有统计学意义（P<0.05）。表明干预后观察组心理状态、生活质量评分以及排尿功能均优于对照组。在尿路感染发生率方面,观察组仅为4.76%（2/72）,低于对照组的19.05%（8/72）,差异有统计学意义（P<0.05）。结论 在脊髓损伤神经源性膀胱患者中应用集束化康复护理联合膀胱功能训练,能够有效改善患者的膀胱功能,降低并发症发生率,提高患者的生活质量。

Objective To investigate the effect of bundled rehabilitation care combined with bladder function training in patients with neurogenic bladder due to spinal cord injury. Methods Patients with neurogenic bladder following spinal cord injury were divided into a control group （receiving conventional rehabilitation care） and an observation group （receiving bundled rehabilitation care plus bladder training）, with 72 cases in each group. There were no statistically significant differences between the two groups of patients in terms of gender ratio, age, and American Spinal Injury Association （ASIA） grading composition at baseline （P>0.05）. Comparisons were made in patients' psychological status [Self-Rating Anxiety Scale （SAS） scores/Self-Rating Depression Scale （SDS） scores], quality of life [Short-Form-36 Health Survey （SF-36） scores], as well as urinary function and incidence of urinary tract infections after 4 weeks of intervention with different nursing programs between the two groups. Results After 4 weeks of nursing care intervention, the observation group demonstrated lower SAS and SDS scores and higher SF-36 scores than the control group （P<0.05）. The observation group also showed lower detrusor pressure and residual urine volume, and higher maximum bladder capacity than the control group （P<0.05）. The results indicated that the observation group demonstrated superior psychological status, quality of life scores, and urinary function compared to the control group. Additionally, the incidence of urinary tract infections was significantly reduced in the observation group （4.76%, 2/72） than that in the control group （19.05%, 8/72） （P<0.05）. Conclusion The application of bundled rehabilitation care combined with bladder function training in patients with neurogenic bladder due to spinal cord injury effectively improves bladder function, reduces complication rates, and enhances patients' quality of life.