Sperling K B
Arch Phys Med Rehabil. 1978 Jan;59(1):4-8.
The intermittent bladder catheterization technique has been proposed as an effective way of eliminating the need for an inlying. Foley catheter in patients with neurovesical dysfunction following spinal cord injury. In the study reported here, a group of 41 male patients with spinal cord injuries achieved a catheter-free state with this method. Of these 41 patients, 19 have been followed for 1 year. Data obtained from the 19 patients are presented here for comparison with data from other recent studies. In the present study, the patients' fluid intake was restricted to 2,000 cc daily. A detrusor reflex was triggered by lower abdominal percussion followed by a Credé maneuver. A 6-hour catheterization schedule was used unless autonomic dysreflexia required more frequent catheterizations. Ascorbic acid, methenamine mandelate and nitrofurantoin were routinely administered, and specific antibiotics were also given following trial off-catheter, depending on the results of urine cultures and sensitivity studies. All patients achieved a catheter-free state in an average time of 17.1 days; no late failures have occurred. Two patients developed vesicoureteral reflux, but no evidence of hydronephrosis was observed. At 1 year only 16% of the patients were found to have infected urine, as compared to 100% at initiation of the trial off-catheter.
间歇性膀胱导尿技术已被提出，作为脊髓损伤后神经膀胱功能障碍患者消除留置导尿管需求的一种有效方法。在本文报道的研究中，一组41名男性脊髓损伤患者通过这种方法实现了无导尿管状态。在这41名患者中，19名已随访1年。此处呈现了从这19名患者获得的数据，以便与其他近期研究的数据进行比较。在本研究中，患者的液体摄入量限制在每日2000毫升。通过下腹部叩诊随后进行克里德手法触发逼尿肌反射。除非自主神经反射异常需要更频繁导尿，否则采用6小时导尿时间表。常规给予抗坏血酸、孟德立胺和呋喃妥因，并且在试行停止导尿后，根据尿培养和药敏研究结果也给予特定抗生素。所有患者平均在17.1天内实现了无导尿管状态；未发生晚期失败情况。两名患者出现膀胱输尿管反流，但未观察到肾积水迹象。在1年时，仅16%的患者尿液被感染，而在试行停止导尿开始时这一比例为100%。
