Clinical Department of Rehabilitation Medicine, Region Östergötland, SE-58185 Linköping, Sweden.
J Rehabil Med. 2018 Feb 13;50(2):181-184. doi: 10.2340/16501977-2298.
To explore whether bladder irrigation with chlorhexidine: (i) can reduce bacteriuria, and (ii) is a practically feasible option in subjects with spinal cord injury practicing intermittent self-catheterization.
A prospective, non-controlled, open, multi-centre study.
Fifty patients with spinal cord injury, practicing intermittent self-catheterization, with a history of recurrent urinary tract infections were screened for bacteriuria at follow-up visits to 4 spinal cord injury centres in Sweden. Twenty-three patients had a positive urine culture (> 105 CFU/ml of > 1 bacterial species), of which 19 completed the study. Subjects proceeded with bladder irrigation, using 120 ml of 0.2% chlorhexidine solution twice daily for up to 7 days. Urine samples were taken twice daily. Response to treatment was defined as reduction in bacterial counts to < 103 CFU/ml.
Fourteen of 19 subjects reduced their bacterial counts to or below the set limit. Subsequent return of above-endpoint bacteriuria was seen in most of the subjects. However, there were significantly fewer subjects with bacteriuria after treatment (p <0.005).
Bladder irrigation with chlorhexidine, using intermittent self-catheterization, reduced bacteriuria in the majority of subjects with spinal cord injury and bacteriuria. The addition of bladder irrigation was practically feasible in the short time-frame of this study.
探讨膀胱冲洗氯己定：（i）是否可以减少菌尿，和（ii）在脊髓损伤患者中是否可行，这些患者实行间歇性自家导尿。
前瞻性、非对照、开放、多中心研究。
在瑞典的 4 个脊髓损伤中心的随访就诊时，对 50 名患有脊髓损伤、实行间歇性自家导尿、有反复尿路感染史的患者进行菌尿筛查。23 名患者尿液培养阳性（>105 CFU/ml >1 种细菌），其中 19 名完成了研究。患者进行膀胱冲洗，每天两次使用 120 ml 0.2%氯己定溶液，持续 7 天。每天采集两次尿液样本。治疗反应定义为细菌计数减少至<103 CFU/ml。
19 名患者中有 14 名将其细菌计数减少到或低于设定限值。大多数患者随后出现细菌计数再次高于终点。然而，治疗后有菌尿的患者明显减少（p<0.005）。
采用间歇性自家导尿对氯己定进行膀胱冲洗可降低大多数脊髓损伤患者的菌尿。在本研究的短时间内，膀胱冲洗的加入是可行的。
