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Rehabilitation Practice and Science

Translated Title

脊髓損傷病患於間歇性導尿訓練過程中尿路感染之探討

Abstract

The difficulty of micturition due to neurogenic bladder in victims of spinal cord injury (SCI) is a common consequence, and also a clinical challenge in the period of rehabilitation for such patients. Intermittent catheterization program (ICP) is a widely employed management for such dysfunction of bladder, however, the occurance of urinary tract infection (UTI) is inevitable. Thus. we carried out this study to investigate the prevention methods of UTI in clinical practice.A total number of 127 patients, between the age of 16 and 80, were enrolled in this study of UTI while undergoing a period of intermittent catheterization. During the training of ICP, there were a total occurance of 145 UTI with 55 and 90 for symptomatic and asymptomatic UTI respectively. The most common bacteria found in UTI were in the order of Escherichia coli., Klebsiella pneumonia and Pseudomonas aeruginosa. In the present study, The observed higher frequency of asymptomatic UTI was believed to be associated with the visceral and somatic afferent dysfuntion of the patients after injury. The frequency fo UTI was not found to be related to the age of patient,level of injury, completeness of neurologic deficit, and type of neurogenic bladder. Regarding the effect of prophylactic agents, Vitamin C used alone was not effective, but the group with combination of Vitamin C and macrodantin was found to have lower rate of UTI. However, there was no significant difference when compared with the control. Therefore, for prevention of UTI during the period of ICP, the most acceptable methods are still: 1). to empty the bladder, 2). to eliminate indwelling catheter, if possible, 3). to prevent bacterial invasion from instrumentation, and 4). to control fluid intake (100cc/hr) and urine output (1500- 2000cc./day). The emphasis of self-catheterization for urine passage in SCI patients with neurogenic bladder is also stressed to avoid UTI.

Language

Traditional Chinese

First Page

150

Last Page

156

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