自我清洁间歇导尿在神经源性膀胱病人中的应用

[目的]探讨自我清洁间歇导尿（IC）在神经源性膀胱（NGB）病人中的应用。[方法]2001年7月至2008年7月采用自我清洁IC治疗NGB病人120例。所有病人经留置尿管纠正肾积水与肾功能不全，但拔除尿管仍不能自主排尿或虽能自主排尿但残余尿量在100mL以上，无泌尿系感染、结石和肾积水，尿动力学检验示膀胱容量300～500mL，残余尿量100～450mL；双上肢肌力4～5级，意识清楚且愿意配合治疗。[结果]本组120例病人经医生指导2～3次后均能成功进行自我清洁IC。培训过程及自我导尿期间未出现异常情况。4例女性病人培训两周后进一步掌握在厕所进行自我清洁IC。随访3～24个月，平均9个月。9例病人在自我清洁IC期间曾发生泌尿系感染，经配合口服抗生素和碱化尿液治疗后复查尿常规结果正常。其余病人尿常规检查无异常，中段尿培养无菌生长。[结论]自我清洁IC治疗NGB操作简便，容易掌握，掌握自我清洁IC能增加患者的自理能力，值得推广应用。

Treatment of Neurogenic Bladder With Clean Intermittent Self-eatheterazation

[Objective] To investigate the treatment of neurogenic bladder （NGB） with clean intermittent self-catheterazation. [Methods] A total of 120 cases of NGB were treated with clean intermittent self-catheter- azation from July 2001 to July 2008. There was no case of urinary system infection, stones or hydronephrosis. Urodynamic examination indicated that bladder volume was 300 to 500 ml and residual urine volume was 100 to 450 ml. Muscle force of upper limbs was grade 4 to 5. All the patients were willing for treatment. [Results] All the patients could succeed in doing clean intermittent self-catheterazation. Four female patients could do clean intermittent self-catheterazation in the toilet. The follow-up was 3-24 months. Nine cases happened urinary system infection, then they were cured. The urine examination of the others was normal. [Conclusion] Treatment of NGB with clean intermittent selLcatheterazation is easy for handling. Mastering clean intermittent self-catheterazation can increase the ability of self-care of patients. It is worthy of wide-spreading.