脊髓損傷患者泌尿併發症及其危險因子之探討

Urological Complication and its Risk Factors for the Patients with Spinal Cord Injury

張時中(Shih-Chung Chang) ； 蔡素如(Su-Ju Tsai) ； 董莉貞(Li-Chen Tung) ； 畢柳鶯(Liu-Ing Bih)

《中華民國復健醫學會雜誌》 28卷2期 (2000/06) Pp. 71-76

摘要

”From January 1993 to June 1996, one hundred and fifty-four spinal cord injury (SCI) patients received urodynamic studies, including urosonography, radionuclide renography, voiding cystoureth-ragrphy, intravenous urography, and/or cystometry. Among the subjects, 125 patients were male (81.2%) and 29 were female (18.8%); there are 133 patients (86.4%) with upper motor neuron lesion and 21 (13.4%) with lower motor neuron lesion.
One hundred and eleven patients (72.7%) had the history of symptomatic urinary tract infection, and urolithiasis was noted in 3 patients (1.9%). Upper urinary deterioration was noted in 81 patients (52.6%), including 29 vesicoureteral reflux and 71 pyelocaliectasis (19 patients had both complica-tions). The percentage of males with urinary tract infection were significantly higher than the females (78.4% vs. 48.3%, p＜0.05), but there was no significant difference of upper urinary deterioration with respect to gender. Patients using indwelling catheters had significantly higher incidence of urinary complications than those without (47% vs. 17.5%, p ＜ 0.05). Higher percent of patients with short duration after injury (＜12 months) kept normal urologic function than those with long duration after injury (＞ 12 months) (62% vs. 40.4%, p ＜ 0.05). There was no significant difference in the incidence of urologic complications between patients with upper and lower motor neuron lesions (46.1% vs. 47.6%, p ＞0.05).
Urologic complication is still one of the main causes of morbidity for patients with SCI. Proper bladder management and periodic urologic surveillance are the essential factors for prevention of urologic complication in SCI patients. Much progress should be made to improve the urologic condition for the SCI patients in our country.

關鍵字

泌尿併發症 ； 危險因子 ； 泌尿系統追蹤 ； 脊髓損傷

並列摘要

”From January 1993 to June 1996, one hundred and fifty-four spinal cord injury (SCI) patients received urodynamic studies, including urosonography, radionuclide renography, voiding cystoureth-ragrphy, intravenous urography, and/or cystometry. Among the subjects, 125 patients were male (81.2%) and 29 were female (18.8%); there are 133 patients (86.4%) with upper motor neuron lesion and 21 (13.4%) with lower motor neuron lesion.
One hundred and eleven patients (72.7%) had the history of symptomatic urinary tract infection, and urolithiasis was noted in 3 patients (1.9%). Upper urinary deterioration was noted in 81 patients (52.6%), including 29 vesicoureteral reflux and 71 pyelocaliectasis (19 patients had both complica-tions). The percentage of males with urinary tract infection were significantly higher than the females (78.4% vs. 48.3%, p＜0.05), but there was no significant difference of upper urinary deterioration with respect to gender. Patients using indwelling catheters had significantly higher incidence of urinary complications than those without (47% vs. 17.5%, p ＜ 0.05). Higher percent of patients with short duration after injury (＜12 months) kept normal urologic function than those with long duration after injury (＞ 12 months) (62% vs. 40.4%, p ＜ 0.05). There was no significant difference in the incidence of urologic complications between patients with upper and lower motor neuron lesions (46.1% vs. 47.6%, p ＞0.05).
Urologic complication is still one of the main causes of morbidity for patients with SCI. Proper bladder management and periodic urologic surveillance are the essential factors for prevention of urologic complication in SCI patients. Much progress should be made to improve the urologic condition for the SCI patients in our country.

並列關鍵字

urologic complication ； risk factor ； urologic surveillance ； spinal cord injury