脳卒中患者の排尿障害パターンと排尿自立に関する考察

Abstract

1)慢性期脳卒中患者213例に膀胱内圧測定を施行したところ, 71.9%が高活動型, 22.5%が正常型, 5.6%が低活動型を示した.2)片麻痺側と膀胱利尿筋機能のタイプあるいは排尿自立の割合とは, 明らかな関連性を示さなかった.3)排尿自立の割合はADLと相関し, 車椅子レベル以上の症例では有意に高かった.4)カテーテルフリーにしえない症例では, 両片麻痺や高度の痴呆に加え, 介護力に乏しいといった社会的因子にも負う点が示唆された

We managed 246 patients with bladder dysfunction due to the first stroke in our hospital between January, 1983 and December, 1988. Of these 221 were in the chronic stage of stroke. A total of 213 patients were evaluated for types of bladder dysfunction by cystometry. We examined the relation between hemiplegic side and type of dysfunction or micturition activity, but obtained no significant relationship. Establishment of voluntary voiding pattern was considered to depend on the improvement of daily life activities. The catheter-free rate was 89.4%, while 10.6% of the patients, who could not receive sufficient nursing care or had severe medical problems, were obliged to keep an indwelling catheter. We conclude that establishment of a bladder retraining program is necessary not only medically but socially for improvement of quality of life in stroke patients.