Hebel J R, Warren J W
Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore 21201.
J Am Geriatr Soc. 1990 Jul;38(7):777-84. doi: 10.1111/j.1532-5415.1990.tb01469.x.
In this study of 4,259 aged patients in 53 randomly selected nursing homes in Maryland, we found that 10% of women and 15% of men used a urine collection device. Among bedfast patients, 47% of women and 58% of men and, among patients with decubitus ulcers, 37% of women and 33% of men were using a urine collection device. The indwelling urethral catheter was the most commonly used device. Indeed, for women, few other options were available: 93% of women used this device. In women, multiple logistic regression analysis indicated that presence of a decubitus ulcer and occupation of a long-term care bed were the attributes most strongly associated with the use of the urethral catheter. Of men with urine collection devices, 43% were using the urethral catheter; poor mobility status was the characteristic most strongly associated with its use. Long-term urethral catheterization has been well studied and is associated with universal bacteriuria and with a number of complications. Options need to be further explored, particularly external urine collection devices for women. Furthermore, because urethral catheterization may be used as a management technique for decubitus ulcers, prevention of the latter may diminish the use of urethral catheters and their subsequent complications.
在这项对马里兰州53家随机挑选的养老院中的4259名老年患者进行的研究中，我们发现10%的女性和15%的男性使用尿液收集装置。在卧床不起的患者中，47%的女性和58%的男性以及在患有褥疮的患者中，37%的女性和33%的男性使用尿液收集装置。留置导尿管是最常用的装置。确实，对于女性来说，几乎没有其他选择：93%的女性使用这种装置。在女性中，多因素逻辑回归分析表明，存在褥疮和占用长期护理床位是与使用导尿管最密切相关的属性。在使用尿液收集装置的男性中，43%使用导尿管；行动不便状态是与其使用最密切相关的特征。长期导尿已得到充分研究，并且与普遍的菌尿症以及许多并发症相关。需要进一步探索其他选择，尤其是针对女性的外部尿液收集装置。此外，由于导尿可能被用作褥疮的一种管理技术，预防褥疮可能会减少导尿管的使用及其后续并发症。
