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來源資料
相關文獻
- 慢性脊髓損傷患者泌尿系統之追蹤及併發症
- 臺灣地區慢性脊髓損傷病患排尿處置之調查報告
- 脊髓損傷患者對泌尿系統併發症的知識、態度及預防行為相關性之探討
- 慢性脊髓病變患者的膀胱處理及尿路預後
- 脊髓損傷患者之功能性電刺激踩車系統
- 脊髓損傷患者性生活之探討
- 居家脊髓損傷患者社會支持狀況及相關因素之探討
- Isobaric Spinal Anesthesia for Paraplegic Patients
- 居家脊髓損傷患者社會支持狀況調查
- Functional Improvement of Uppor Extremity in Cervical Spinal Cord Injured Patient after Tendon Transfer: A Case Report
頁籤選單縮合
題名 | 慢性脊髓損傷患者泌尿系統之追蹤及併發症 |
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作者姓名(中文) | 畢柳鶯; 陳玲芳; 傅家璋; | 書刊名 | 復健醫學會雜誌 |
卷期 | 22:1 1994.06[民83.06] |
頁次 | 頁83-90 |
分類號 | 415.945 |
關鍵詞 | 泌尿系統併發症; 泌尿系統追蹤檢查; 脊髓損傷; Urologic complications; Urologic surveillance; Spinal cord injury; |
語文 | 中文(Chinese) |
中文摘要 | 泌尿系統併發症是脊髓損傷後罹病率增高最常見的原因之一。脊髓損傷後即使膀胱訓練成功,仍可能發生各種泌尿道併發症,唯有長期追蹤並修正排尿方法,才可能維護腎臟功能。本研究對象為1991年9月至1993年8月於本院接受完整泌尿腎臟功能檢查,發病兩年以上之60位脊髓損傷患者。男性49位中,32位(65.3%)接受過膀胱訓練,但住院時32位中僅14位(43.8%)殘尿量少於100ml。檢查結果共21例發現異常(42.9%),包括16例有單側或雙側之膀胱輸尿管逆流,2例有中度以上腎盂腎盞擴張,腎結石2例及膀胱結石2例(有一例同時併發肺胱輸尿管逆流)。其中5例(10.2%)已有腎功能不足現象。上尿路系統併發症(逆流16例,腎盂擴張2例,腎結石2例)之發生率高達40.8%。女性共11位,9位(81.8%)接受過肺胱訓練,住院時殘尿量均少於150ml。檢查結果僅1例有單側輸尿管逆流,其併發症發生率(9.0%)明顯較男性低,有統計學上意義(P<0.05)。 有上尿路併發症及膀胱結石的22位病人中,17位完全無症狀,有15位平均已受傷7.1±5.7年但從未接受過泌尿道追蹤檢查。男性病人僅一例之前因輸尿管逆流接受過擴約肌切開手術。本報告顯示臺灣中部地區的男性脊髓損傷患者泌尿道併發症發生率偏高,應加強早期之膀胱訓練,後期之泌尿系統追蹤檢查,以期及早發現併發症保存腎臟功能。 |
英文摘要 | Renal failure was once the leading cause of death in patients with chronic spinal cord lesions. In western countries, dramatic improvements in urologic care enhancing patient survival have occurred in the last 25 years. Nonetheless, urological complications continue to be the major morbidity is spinal cord injured patients. The purpose of our investigation was to survey the urological complications in patients suffered from spinal cord injuries (SCI) for more than 2 years in Taiwan. Forty-nine male and 11 female patients had comprehensive urological studies prospectively. Of the 49 male patients, 32(65.3%) had had ladder training in the acute stage. Only 14(43.8%) of the 32 patients had post-voiding residuals (PVR) less than 100 ml. Of the 11 female patients, 9(81.8%) had had bladder training in the acute stage, all the patients had PVR less than 150 ml. Twenty-one (42.9%) of the 49 male patients revealed urologic complications, including 16 with vesico-ureteral reflux (VUR), 2 with moderate pyelocaliectasis, 2 with renal stones and 2 with bladder stones (one patients had both bladder stones and VUR). Five (10.2%) patients had significant renal impairment (Ccr <50 ml/min and serum Cr>1.5 mg/dl). Only one (9.0%) of the 11 female patients had urologic complication (unilateral VUR), the incidence was significantly less than the male patients (p<0.05). As to the 22 patients with urologic complications. 17 of them did not have any urological symptoms when they were examined. Fifteen patients had never had previous urological examinations. We found that the incidence of urologic complications was relatively high for the male SCI patients in middle Taiwan. In order to prevent urologic complications and preserve the renal function, appropriate bladder management and regular urological surveillance should be emphasized to both the medical personnel and the SCI patients in Taiwan. |
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