自動間歇排尿装置(ブラドマン)の脊髄損傷患者における膀胱洗浄の安全性と排尿訓練の有用性について

Abstract

1)ブラドマンによる膀胱洗浄を施行したところ洗浄液の注入に伴いサイホン現象が生じ, 間歇的な排液が可能であった。2)膀胱洗浄前後での尿の外観および尿中白血球数に著しい改善が認められた。3)ブラドマンの使用に際して副作用は1例も観察されず安全であった。つぎに, 脊髄損傷患者の排尿訓練にブラドマンの適用を試みた。1)ブラドマンは圧力応答性の装置であるため, 患者自身および医療従事者が安心して使うことができた。2)膀胱容量と膀胱コンプライアンス値が上昇し, 膀胱機能の改善が認められた。3)視覚的にいつ排尿訓練をすればよいのか患者が判断でき, 排尿方法を覚えるのに役立った。4)膀胱訓練後の排尿では全例にQOLの改善が認められた。5)ブラドマン使用に伴う副作用はなかった

First, we used BLADMAN system for bladder irrigation on 47 outpatients with spinal cord injury. A syphon phenomenon of BLADMAN was applied to irrigation of the bladder. Irrigating liquid was a physiological saline solution and its volume was 500-1, 000 ml. Bladder irrigation was done for 1 to 2 hours. As a result of bladder irrigation by this system, urine was clearer and the number of leucocyte in urine was decreased. There was no trouble and no side effects occurred while using this system. BLADMAN is safe and considered to be applicable to the patients with spinal cord injury. Secondly, we used BLADMAN for bladder training to the patients with spinal cord injury. Bladder training was done for 7 to 28 days on the patients with indwelling urethral catheter. The bladder function was compared before and after training. Bladder volume and compliance were significantly improved. There was no trouble while the patients used the BLADMAN system. We consider that the BLADMAN system is one of the best methods of bladder training for the patients with spinal cord injury.