再谈清洁间歇导尿对小儿神经源性膀胱的治疗价值

Application of clean intermittent catheterization in the treatment of neurogenic bladder in children

导尿技术和导尿材料的不断革新,直到现代清洁间歇导尿(clean intermittent catheterization,CIC)技术的诞生,经过了漫长的历史演变过程。神经源性膀胱(neurogenic bladder,NB)是导致儿童下尿路功能障碍的主要原因,患者常出现反复泌尿系统感染、排尿困难或尿失禁等,引起肾、输尿管积水及膀胱输尿管反流,造成肾功能损害,甚至导致肾功能衰竭。随着CIC在全世界范围内开展实施,NB患者病死率大幅下降,生活质量得到提高。CIC已被国际尿控协会作为排空膀胱的首选方法和治疗NB的重要手段。医生、患者和家长共同协作,为NB患者制定个性化的CIC方案,可实现CIC的最大价值。

The technological innovations of catheterization and catheterization materials have gone through a long history until the emergence of clean intermittent catheterization(CIC)technology.Neurogenic bladder(NB)is a major cause of lower urinary tract dysfunction in children.Children often have recurrent urinary tract infections,dysuria or urinary incontinence,resulting in hydroneureter and vesicoureteral reflux,renal impairment and death due to renal failure.With the global implementation of CIC,the mortality rate of NB children declined markedly and the quality-of-life improved.CIC has been recognized by International Continence Society as a first choice for bladder emptying and an important treatment for NB.Physicians,children and parents should cooperate to develop a personalized CIC program for NB children to maximize the value of CIC.