膀胱管理方式对脊髓损伤患者泌尿系结石形成的影响

Influence of bladder management on urinary stone formation in patients with spinal cord injury

中文关键词:  脊髓损伤  泌尿系结石  泌尿系感染  影像尿动力学

英文关键词:Spinal cord injury  Urinary stone  Urinary infection  Video urodynamics

中文摘要:

  【摘要】 目的：探讨膀胱管理方式对脊髓损伤患者泌尿系结石形成的影响。方法：2005年6月~2010年6月，我科收治337例脊髓损伤后排尿功能障碍的患者，入院前膀胱管理方式：膀胱造瘘47例，留置尿管定期更换51例，叩击排尿29例，腹压排尿31例，应用外部集尿器35例，间歇导尿144例。对所有患者行泌尿系B超检查，同时行尿常规检查、尿细菌培养和影像尿动力学检查。结果：共有128例患者合并泌尿系结石，其中膀胱造瘘32例，留置尿管定期更换34例，叩击排尿19例，腹压排尿11例，应用外部集尿器20例，间歇导尿12例。间歇导尿泌尿系结石的发生率最低，与其他方式比较均有显著性差异（P<0.05）。128例患者中120例同时存在泌尿系感染，影像尿动力学均存在异常。结论：膀胱管理方式对脊髓损伤后泌尿系结石的形成有重要影响，间歇导尿可明显降低泌尿系结石的发生率。

英文摘要:

  【Abstract】 Objective：To investigate the influence of bladder management on urinary stone formation in patients with spinal cord injury（SCI）.Method：From June 2005 to June 2010，337 cases with voiding dysfunction after spinal cord injury were included in this series.Bladder management before admission included bladder stoma in 47 cases，regular replacement of indwelling catheter in 51 cases，triggered reflex voiding in 29 cases，voiding by abdominal straining in 31 cases，condom catheters with urine collection devices in 35 cases，intermittent catheterization in 144 cases.All patients accepted ultrasound examination of urinary system，urine routine examination，urine bacterial culture and video urodynamics examination.Result：A total of 128 SCI cases were complicated with urinary calculi，including bladder stoma in 32 cases，regular replacement of indwelling catheter in 34 cases，triggered reflex voiding in 19 cases，voiding by abdominal straining in 11 cases，condom catheters with urine collection devices in 20 cases，intermittent catheterization in 12 cases.Intermittent catheterization had the lowest incidence of urinary stones formation compared with the other means（P<0.05）.In 128 patients with urinary calculi，120 patients presented with urinary tract infection and abnormal video urodynamics.Conclusion：Bladder management after spinal cord injury has major impact on urinary stones formation. Intermittent catheterization can decrease the incidence of urinary stones.