摘要
目的探讨清洁间歇导尿（CIC）联合睡眠时留置导尿对神经原性膀胱患儿上尿路的影响。方法选取2007年3月至2008年2月我院尿动力学中心确诊为神经原性膀胱的患儿53例，随机分为CIC组（对照组27例）和CIC联合睡眠时留置尿管组（睡眠时留置尿管组26例）。比较两组随访2年后膀胱尿路X线造影或影像尿动力学参数、尿路感染、肾积水的发生情况。结果两组治疗后膀胱安全容量（SBC）分别为（213±24）ml和（190±21）ml、膀胱顺应性（BC）分别为（8．21±0．8）ml／cm H2O和（5．13±0．9）ml／cm H2O均有增加，膀胱漏尿点压（DLPP）（36．5±10．2）cmH2O和（42．9±11．3）cmH2O有所降低；CIC联合睡眠时留置尿管组随访时在SBC、BC和DLPP的改善方面明显高于单纯CIC组，差异有统计学意义。两组菌尿及尿路感染发生率差异无明显统计学意义（P〉0．05）；肾积水、膀胱输尿管反流的改善差异有统计学意义（P〈0．05）。结论CIC联合睡眠时留置尿管未见增加尿路感染机会，有助于改善神经原性膀胱患儿上尿路损害，对上尿路有保护作用。
Objective To investigate the effects of clean intermittent catheterization （CIC） cou- pled with indwelling urinary catheterization during sleep on the upper urinary tract in children with neurogenic bladder. Methods Fifty-three children with neurogenie bladder diagnosed by urodynamie were divided into experimental group （26 cases） and control group （27 cases） randomly. The control group was treated with CIC, whereas CIC coupled with indwelling urinary catheterization during night were set as experimental group. After 2 years follow up, X-ray urography or videourodynamie exami- nation were performed in them and the relative parameters were summarized and analyzed between two groups. Results The safety bladder capacity （SBC） and bladder compliance （BC） of all children in- creased while the DLPP decreased after 2 years of treatment, and all these parameters in experimental group had a better improvement than those in control group. The alleviative rate of hydronephrosis in experimental group was higher than that of control group （P〉O. 05）, while the incidence of bacterial urine and urinary infection between two groups had no statistical significance （P〉O. 05）. Conchtsions CIC coupled with indwelling urinary catheterization during sleep plays a better protective role than CIC alone for children with neurogenie bladder.
出处
《中华小儿外科杂志》
CSCD
北大核心
2012年第6期455-457,共3页
Chinese Journal of Pediatric Surgery
关键词
膀胱
神经原性
导尿管插入术
Urinary bladder,neurogenie Urinary catheterization
