Belmin J, Hervias Y, Avellano E, Oudart O, Durand I
Service de Gérontologie Médicale, Hôpital René Muret-Bigottini, Sevran, France.
J Am Geriatr Soc. 1993 Nov;41(11):1182-6. doi: 10.1111/j.1532-5415.1993.tb07300.x.
To assess the reliability for biochemical and microbiological analysis of urine collection from disposable diapers in elderly women with severe urinary incontinence.
Cross-sectional comparison of two methods of collection.
Urine was sampled from 52 women inpatients (aged 68-98 years) in a geriatric hospital ward by pressing a diaper which the patient had worn for 3 hours. Just after this collection, another sample was obtained by retrograde catheterization. Both samples were analyzed for sodium, potassium, chloride, proteins, urea, creatinine, calcium, and phosphate and for cell counts, the presence of bacteria, and bacteria culture.
For all the biochemical parameters, the urinary concentrations obtained by the two methods were strongly and significantly correlated. The following differences (mean and range, in mmol/L) were found between the values obtained by the two methods: sodium: 6.05 (-26 to 27), potassium: (-16 to 14), chloride: -1.13 (-24 to 23), urea: 6.85 (-33 to 37), creatinine: 0.24 (-0.95 to 1.45), calcium: -0.22 (-1.27 to 1.70), and phosphate: 2.17 (-2.5 to 13.4). For diagnosis of urinary tract infection, agreement between the two methods was good (kappa = 0.84), and bacteriological agreement was obtained in 25 out of 28 cases (89%). However, for diagnosis of microscopic hematuria, agreement was poor (kappa = 0.50), probably due to the overestimation of the true urinary red cell count in the samples collected by catheterization.
For routine microbiological and biochemical analysis, urine extraction from disposable diapers is a simple and reasonably reliable method of sampling urine from elderly women with severe incontinence.
评估从患有严重尿失禁的老年女性一次性尿布中收集尿液进行生化和微生物分析的可靠性。
两种收集方法的横断面比较。
在一家老年医院病房，通过按压患者佩戴3小时的尿布，从52名住院女性患者（年龄68 - 98岁）中采集尿液。在此次采集后立即通过逆行导尿术获取另一份样本。对两份样本进行钠、钾、氯、蛋白质、尿素、肌酐、钙和磷酸盐分析以及细胞计数、细菌存在情况和细菌培养。
对于所有生化参数，两种方法获得的尿液浓度具有强烈且显著的相关性。两种方法获得的值之间存在以下差异（均值和范围，单位为mmol/L）：钠：6.05（-26至27），钾：（-16至14），氯：-1.13（-24至23），尿素：6.85（-33至37），肌酐：0.24（-0.95至1.45），钙：-0.22（-1.27至1.70），磷酸盐：2.17（-2.5至13.4）。对于尿路感染的诊断，两种方法之间的一致性良好（kappa = 0.84），28例中有25例（89%）获得了细菌学一致性。然而，对于镜下血尿的诊断，一致性较差（kappa = 0.50），可能是由于导尿采集样本中对真实尿红细胞计数的高估。
对于常规微生物学和生化分析，从一次性尿布中提取尿液是一种从患有严重尿失禁的老年女性中采样尿液的简单且合理可靠的方法。
