Department of Urology, Qingdao Municipal Hospital, Qingdao University, Qingdao City, Shandong Province, China.
Department of Urology, Qilu Hospital, Shandong University School of Medicine, Jinan City, Shandong Province, China.
J Clin Nurs. 2019 Jul;28(13-14):2499-2505. doi: 10.1111/jocn.14208. Epub 2019 Mar 28.
To assess the clinical effect of the multifunctional suprapubic catheter (MSC) on occurrence of cystospasm, catheter occlusion, the catheter-related urinary tract infection and remission of overactivity bladder, by comparing with the conventional suprapubic catheter (CSC) in patients with permanent suprapubic cystostomy.
The conventional suprapubic catheter usually presents with high incidence of catheter-associated complications.
A prospective randomised clinical trial in a single centre.
Between January 2014 and January 2015, a total of 91 consecutive patients with permanent suprapubic cystostomy were prospectively randomised into two groups: the MSC group (n = 43) and CSC group (n = 48).
Our results showed that the total times of cystospasm in the MSC group were significantly less than that in the CSC group during the follow-up time (p < .001). In addition, the mean spasmodic duration per time in the MSC group was significantly shorter than that in the CSC group (p < .001). Besides, catheter occlusions were observed in 23 (25.27%) patients, including 5 (11.63%) in the MSC group and 18 (37.50%) in the CSC group (p = .005). The lower rate of positive urine culture was also found in the MSC group but with no significant difference (p = .540). Furthermore, the urodynamic measurement data demonstrated that the patients in the MSC group had a greater remission rate of overactivity bladder after catheter change (p < .001).
The present data showed that the multifunctional suprapubic catheter could significantly reduce the incidence of catheter occlusion, ameliorate the symptom of cystospasm and relieve the overactivity bladder, but have no influence on the catheter-related urinary tract infection.
The application of our self-devised multifunctional suprapubic catheter may result in better management of the patients with permanent suprapubic cystostomy.
通过与传统耻骨上导管（CSC）比较，评估多功能耻骨上导管（MSC）在永久性耻骨上膀胱造瘘患者中对膀胱痉挛、导管阻塞、导管相关尿路感染和过度活动膀胱缓解的临床效果。
传统耻骨上导管通常伴有较高的导管相关并发症发生率。
单中心前瞻性随机临床试验。
2014 年 1 月至 2015 年 1 月，前瞻性随机将 91 例连续永久性耻骨上膀胱造瘘患者分为两组：MSC 组（n=43）和 CSC 组（n=48）。
我们的结果显示，MSC 组在随访期间的总痉挛次数明显少于 CSC 组（p<0.001）。此外，MSC 组每次痉挛的平均持续时间也明显短于 CSC 组（p<0.001）。另外，23 例（25.27%）患者出现导管阻塞，MSC 组 5 例（11.63%），CSC 组 18 例（37.50%）（p=0.005）。MSC 组的尿液培养阳性率也较低，但差异无统计学意义（p=0.540）。此外，尿动力学测量数据显示，导管更换后 MSC 组过度活动膀胱的缓解率更高（p<0.001）。
目前的数据表明，多功能耻骨上导管可显著降低导管阻塞的发生率，改善膀胱痉挛症状，缓解过度活动膀胱，但对导管相关尿路感染无影响。
我们自行设计的多功能耻骨上导管的应用可能会使永久性耻骨上膀胱造瘘患者的管理得到改善。
