Kunin C M, Chin Q F, Chambers S
Am J Med. 1987 Mar;82(3):405-11. doi: 10.1016/0002-9343(87)90438-4.
In order to define the natural history of indwelling urinary catheters in the elderly, 50 patients aged 65 years or older were followed. Their catheters had been in place for a mean of 33.2 days. When removed, 40.4 percent were blocked or showed poor flow. After the catheters were changed, the 14-day "catheter life" was 78 percent. About half the population had blocked catheters. They had a 14-day "catheter life" of only 31.8 percent (p = less than 0.01). Patients with blocked catheters ("blockers") excreted more alkaline urine, calcium, protein, and mucin than patients without blocked catheters ("nonblockers"), but urea-splitting bacteria were no more frequent. The mortality was not significantly different. Flow of water through catheters was closely related to extent of encrustations. Encrustations formed uniformly throughout the catheter lumen except when the tip was obstructed. The distribution and number of species of microorganisms (three and a half per specimen) were virtually identical in catheter and bladder urine, but the counts in the catheter urine were more frequently greater than 100,000 cfu/ml (p = less than 0.01). Patients with blocked catheters appear to be metabolically different from patients without blocked catheters and should have their catheters changed at seven to 10 days to avoid obstruction.
为明确老年患者留置导尿管的自然病程，对50例65岁及以上患者进行了随访。他们的导尿管平均留置时间为33.2天。拔除时，40.4%的导尿管堵塞或引流不畅。更换导尿管后，14天的“导尿管使用寿命”为78%。约一半患者的导尿管堵塞。他们的14天“导尿管使用寿命”仅为31.8%（p<0.01）。与未堵塞导尿管的患者（“非堵塞者”）相比，导尿管堵塞的患者（“堵塞者”）排出的碱性尿液、钙、蛋白质和粘蛋白更多，但尿素分解菌的出现频率并无差异。死亡率无显著差异。水流经导尿管的情况与结痂程度密切相关。除尖端堵塞外，导尿管内腔各处均均匀形成结痂。导尿管尿液和膀胱尿液中的微生物种类分布及数量（每个标本3.5种）基本相同，但导尿管尿液中的菌数更常大于100,000 cfu/ml（p<0.01）。导尿管堵塞的患者似乎在代谢方面与未堵塞导尿管的患者不同，应在7至10天更换导尿管以避免堵塞。
