定时开放耻骨上膀胱造瘘与清洁间歇导尿治疗男性高位脊髓损伤伴神经源性下尿路功能障碍的疗效比较  

Comparison of time-opening suprapubic cystostomy versus clean intermittent catheterization for high spinal cord injury in male patients with neurogenic lower urinary tract dysfunction

作　　者：周理林 潘楚灶[1] 龚国毅[1] 余文俊[1] 曾健文[1] 陈晖 ZHOU Li-Un;PAN Chu-zao;GONG Guo-yi(Department of Urology,The Sixth Affiliated Hospital of Guangzhou Medical University(Qingyuan People's Hospital),Qingyuan 511500,China;Work injury Rehabilitation Hospital of Guangdong Province,Guangzhou 510000,China)

机构地区：[1]广州医科大学附属第六医院(清远市人民医院)泌尿外科,广东清远511500 [2]广东省工伤康复医院,广东广州510000

出　　处：《吉林医学》2019年第3期535-537,共3页Jilin Medical Journal

摘　　要：目的:比较定时开放耻骨上膀胱造瘘与清洁间歇导尿治疗男性高位脊髓损伤(C_5以上)伴神经源性下尿路功能障碍患者的疗效,为选择更优的膀胱管理方案提供依据。方法:选取2011年1月～2017年12月因高位脊髓损伤伴神经源性下尿路功能障碍行耻骨上膀胱造瘘或清洁间歇导尿的45例男性患者为研究对象,并随访1年,比较两组治疗前后肾功能的变化情况及两组治疗后出现症状性尿路感染、膀胱结石、肉眼血尿、睾丸附睾炎、尿道狭窄等并发症的发生率。结果:两组症状性尿路感染、膀胱结石、肉眼血尿发生率比较,差异无统计学意义(P>0.05),两组患者的肾功能均能得到较好的保护,但清洁间歇导尿组分别有4例睾丸附睾炎及3例尿道狭窄发生。结论:对于高位脊髓损伤(C_5以上)患者的膀胱管理,定时开放耻骨上膀胱造瘘优于清洁间歇导尿,值得临床推广应用。Objective To compare the effect of time-opening suprapubic cystostomy versus clean intermittent catheterization for high spinal cord injury(above level C5) in male patients with neurogenic lower urinary tract dysfunction,for selecting a better bladder management scheme.Method Clinical data of 45 male patients who underwent suprapubic cystostomy or clean intermittent catheterization due to high spinal cord injury with neurogenic lower urinary tract dysfunction from January 2011 to December 2017 were collected and followed up for one year.The change of renal function before and after treatment and the incidence of symptomatic urinary tract infection,bladder stones,gross hematuria,testicular epididymitis,urethral stricture and other complications after treatment in the two groups were compared.Results There was no significant difference in the incidence of symptomatic urinary tract infection,bladder stones and gross hematuria between the two groups(P>0.05). The renal function of the two groups was well protected,but there were 4 cases of testicular epididymitis and 3 cases of urethral stricture in the clean intermittent catheterization group.Conclusion For bladder management of patients with high spinal cord injury(above level C5),time-opening suprapubic cystostomy is superior to clean intermittent catheterization,which is worthy of clinical application.

关 键 词：耻骨上膀胱造瘘 清洁间歇导尿 脊髓损伤 

分 类 号：R699[医药卫生—泌尿科学] R651.2[医药卫生—外科学]