Sugimura Takayuki, Arnold Edwin, English Sharon, Moore James
Department of Urology, Christchurch Hospital, Christchurch, New Zealand.
BJU Int. 2008 Jun;101(11):1396-400. doi: 10.1111/j.1464-410X.2007.07404.x. Epub 2008 Jan 8.
To assess whether chronic suprapubic catheterization (SPC) in patients with spinal cord injury (SCI) is associated with a higher incidence of significant urinary tract complications than in patients whose urinary tracts are managed by other methods.
Our experience suggested that the incidence of complications in patients with SCI and SPC was acceptable and relatively low. Between 1988 and 2001, 1018 patients were admitted to our unit after SCI; 149 were managed by SPC and we retrospectively reviewed them, with a mean follow-up of 6 years. There were no complications in 49% of patients. Most complications were minor (urinary tract infection 27%, bladder stones 22%) and were easily managed. Only 20 patients had upper tract complications. Nine patients had renal scarring and 14, all quadriplegic, had upper tract calculi. One patient developed well-differentiated superficial transitional cell bladder cancer.
Patients with SCI often prefer SPC than other methods offered to them, because of quality-of-life issues. The incidence of significant complications might not be as high as previously reported, and with a commitment to careful follow-up, SPC can be a safe option for carefully selected patients if adequate surveillance can be ensured.
评估脊髓损伤（SCI）患者长期耻骨上膀胱造瘘术（SPC）与采用其他方法管理尿路的患者相比，是否会导致更高的严重尿路并发症发生率。
我们的经验表明，SCI和SPC患者的并发症发生率是可以接受的且相对较低。1988年至2001年间，1018例SCI患者入住我们科室；149例采用SPC治疗，我们对他们进行了回顾性研究，平均随访6年。49%的患者无并发症。大多数并发症较轻微（尿路感染27%，膀胱结石22%），且易于处理。只有20例患者出现上尿路并发症。9例患者有肾瘢痕，14例四肢瘫痪患者有上尿路结石。1例患者发生高分化浅表性移行细胞膀胱癌。
由于生活质量问题，SCI患者通常比其他治疗方法更喜欢SPC。严重并发症的发生率可能不像以前报道的那么高，并且如果能确保充分的监测，对于精心挑选的患者，在认真随访的情况下，SPC可以是一种安全的选择。
