Nwadiaro H C, Nnamonu M I, Ramyil V M, Igun G O
Orthopaedic unit, Department of Surgery, Jos University Teaching Hospital, Jos, Plateau State, Nigeria.
Niger J Med. 2007 Oct-Dec;16(4):318-21. doi: 10.4314/njm.v16i4.37329.
The objective of this study was, to prospectively and retro respectively evaluate urethral catheterization (UC) versus supra-pubic cystostomy (SPC) in prevention of urinary tract infection (UTI) in patients with spinal cord injury lesion.
A total of 125 patients with neurogenic bladder and a mean age of 30 years had UC (n=80) and SPC (n=40) at the Jos University Teaching Hospital (JUTH) between January 1984 and June 2005.
Episodes of UTI were significantly more; UC 65% versus 14% forS PC (P< O 0 5). Urinary tract infection occurred relatively late in the course of admission, in patient who had SPC. Patients in SPC group were significantly satisfied with this management option; 57% versus 8% for UC. Similarly, mortality at 1 year post admission was significantly less; 9% versus 36% for UC and death due to UTI related septicaemia was 33% versus 18% respectively.
It was concluded that SPC was a better management option since it was associated with a low morbidity, better quality of life and a longer life expectancy than UC.
本研究的目的是前瞻性和回顾性地评估脊髓损伤患者中，尿道导尿（UC）与耻骨上膀胱造瘘术（SPC）在预防尿路感染（UTI）方面的效果。
1984年1月至2005年6月期间，在乔斯大学教学医院（JUTH），共有125例平均年龄为30岁的神经源性膀胱患者接受了尿道导尿（n = 80）和耻骨上膀胱造瘘术（n = 40）。
尿路感染的发生率显著更高；尿道导尿组为65%，而耻骨上膀胱造瘘术组为14%（P < 0.05）。耻骨上膀胱造瘘术患者的尿路感染在入院过程中出现得相对较晚。耻骨上膀胱造瘘术组的患者对这种治疗选择的满意度显著更高；分别为57%和8%（尿道导尿组）。同样，入院后1年的死亡率显著更低；尿道导尿组为36%，耻骨上膀胱造瘘术组为9%，因尿路感染相关败血症导致的死亡分别为33%和18%。
得出的结论是，耻骨上膀胱造瘘术是一种更好的治疗选择，因为与尿道导尿相比，它具有发病率低、生活质量更好和预期寿命更长的特点。
