夜尿的症狀會影響睡眠品質進而影響患者生活品質，特別是對於老年人來說，若是一個晚上需要起床小便超過二次，常發生跌倒的意外事件而造成嚴重併發症。對於脊髓損傷(SCI)的患者，除了夜間多尿，也經常發現會出現腿部水腫，而在夜間，由於自然排泄機制可導致夜間多尿症（NP）使的水腫減少。目前用於治療夜間多尿症的去氨加壓素（DDAVP）在SCI患者使用的證據非常有限，並且缺乏隨機對照試驗。 並且使用去氨加壓素作為藥物治療方式可能的副作用例如水中毒和低鈉血症也值得考慮。 本研究是為了評估在SCI患者，非藥物的治療方式對下肢水腫和夜間多尿症（NP）的可能影響，本研究探討了兩種方式—加壓繃帶和間歇性充氣加壓（IPC），並探討下肢水腫和夜間多尿兩者病理學之間的可能相互關係。

本研究的研究對象均為SCI患者且輪椅使用者，合併有雙腿水腫並且可能同時有符合夜間多尿症的診斷（夜間尿量與白天相同或更多），在脊椎損傷之後進行首次復健，參加為期三週的復健計劃。總共收集24位年齡在21至63歲之間的患者。在第一周，收集初始數據。在第二週，從患者躺下的那一刻開始執行IPC。在第三週，患者穿著多層加壓繃帶。在受試者早晨坐起來前，以及他們躺在床上時測量腿圍。並且記錄其24小時排尿日記(frequency-volume chart）。

結果顯示，比較早晚之間和三種治療方法之間，雙腿的腿部容積顯著不同。加壓繃帶組和初始相比，以及加壓繃帶組和IPC相比均存在顯著性差異。然而IPC組則與初始相比沒有顯著差異。當不使用任何治療或接受IPC時，臥床休息期間尿液產生量顯著增加。反之，使用加壓繃帶組，臥床休息期間和睡眠期間相比，與初始相比及IPC對照下，尿液的產生量顯著降低。也就是說，加壓繃帶作為治療組，其夜間絕對排尿量顯著減少（P <0.001）。此外，白天腿部容積變化與尿液產生比率之間存在顯著的正相關關係，腿部容積增加100 mL與尿液產生比率增加有關(透過對數轉化後比率為8％)。

引起夜間多尿症的原因很多，包括腦下垂體分泌的抗利尿賀爾蒙（ADH, Vasopressin）不足、腎病症候群，鬱血性心臟病，靜脈循環不良，淋巴水腫等造成周邊水腫、睡眠呼吸中止症候群甚至失眠等等。以周邊四肢水腫來說，在平躺睡覺時，周邊四肢的水份才回流至血液中，使的患者在平躺後開始排出多餘的水份，引起夜間多尿症。而透過使用繃帶或長襪的加壓療法做為治療腿部浮腫的基本療法，其主要原理是透過加壓，減少液體進入細胞間隙的過濾並增加淋巴管引流。多層加壓繃帶可以逐漸減小從遠端到近端的壓力，透過這種機制抵消了靜水壓力並將液體推回血液和淋巴管。對於患有腿部水腫或NP的SCI患者，水腫的形成和尿液的產生似乎彼此之間相互有關。因此，透過本研究顯示，使用加壓繃帶被證明是改善腿部水腫和NP的治療選擇。雖然臨床上未必遇到那麼多脊椎損傷的病人，但從學理上來說，若是病人因為其他原因有周邊水腫合併夜間多尿，在藥物治療的選擇之外，也許可以考慮採用加壓繃帶此非藥物的治療方式。

Objective
To evaluate the possible influence of non-pharmacological interventions, such as compressive bandages and intermittent pneumatic compression (IPC), on leg oedema and nocturnal polyuria (NP), and the possible interrelation between both pathologies in patients with spinal cord injury (SCI), as patients with SCI often have leg oedema and during the night the oedema decreases as a result of natural drainage mechanisms that can cause NP.

Patients and Methods
Patients with SCI who followed their first rehabilitation after their SCI with bilateral leg oedema and/or with as much or a larger urine volume at night as during the day. The patients were all wheelchair users and followed the rehabilitation programme daily for 3 weeks. In all, 24 patients, aged between 21 and 63 years, were selected for participation in the 3-week rehabilitation programme. During the first week, baseline data were collected. During the second week, IPC was executed from the moment the patient went to lie down. During the third week, the patients wore multilayer compressive bandages. Leg circumference was measured in the morning before sitting up and at the moment they went to lie down in bed. During each study week, a daily frequency-volume chart (24 h) was completed.

Results
The leg volume of both legs was significantly different between the morning and evening (right leg F = 103.90, P < 0.001; left leg F = 100.77, P < 0.001) and between the three treatments (right F = 9.70, P < 0.001; left F = 9.66, P < 0.001). There was a significant difference between the compressive bandages and the baseline period (right and left leg, both P < 0.001) and between the compressive bandages and IPC (right leg P = 0.009 and left leg P = 0.015). There was no significant difference between IPC and the baseline. When no treatment or IPC was used, urine production was significantly higher during the bed-rest period. The urine production was significantly lower comparing the use of compressive bandages to baseline and IPC, during bed rest (P = 0.009) and during sleep (P < 0.001). There was a significant decrease in absolute voided volume at night with the compressive bandages as treatment (P < 0.001). There was a significant positive association between the leg volume change during the day and the urine-production ratio, 100 mL increase in leg volume was associated with 8% increase in the log-transformed urine-production ratio. >Conclusions
There are alternative treatment options for patients with SCI who have oedema or NP. Oedema formation and urine production appear to be related to each other. Therefore, the use of compressive bandages was shown to be a valuable treatment option to improve both leg oedema and NP.