尿道留置カテーテル離脱にむけた急性期病院での排尿管理の検討 : 寝たきり状態の有無と尿排出障害の関連性

Abstract

In this study we investigated the influences of decreased levels of activities of daily living (ADL), especially in bedridden patients, on lower urinary tract dysfunction and urinary management during hospital care. All 1, 106 non-urological inpatients (896 non-bedridden patients and 210 bedridden patients) with an indwelling urethral catheter treated at Noto General Hospital between April 2006 and October 2009 were retrospectively evaluated. Maximum bladder capacity and post-void residual urine volume (PVR) were evaluated with uroflowmetry or voiding cystourethrography at the time the catheter was removed. Clean intermittent catheterization (CIC) and drug administration were performed for patients who had a PVR of 100 ml or more. Bedridden patients required urinary interventions at a higher rate than did non-bedridden patients (bedridden : 29.0%, non-bedridden : 17.6%). Although indwelling urethral catheters were reinserted in 13 patients in the bedridden group and 16 patients in the non-bedridden group, many patients in both groups could be free from the catheter. Our results indicate that patients with low ADL are vulnerable to impaired bladder emptying, and early diagnosis of impaired bladder emptying and active urinary management are required to solve their urinary problems.