PDF(Pubmed)
Abstract：
Intermittent catheterization (IC) utilizing conventional eyelets catheters (CECs) for bladder drainage has long been the standard of care. However, when the tissue of the lower urinary tract comes in close proximity to the eyelets, mucosal suction often occurs, resulting in microtrauma. This study investigates the impact of replacing conventional eyelets with a drainage zone featuring multiple micro-holes, distributing pressure over a larger area. Lower pressures limit the suction of surrounding tissue into these micro-holes, significantly reducing tissue microtrauma. Using an ex vivo model replicating the intra-abdominal pressure conditions of the bladder, the intra-catheter pressure was measured during drainage. When mucosal suction occurred, intra-catheter images were recorded. Subsequently affected tissue samples were investigated histologically. The negative pressure peaks caused by mucosal suction were found to be very high for the CECs, leading to exfoliation of the bladder urothelium and breakage of the urothelial barrier. However, a micro-hole zone catheter (MHZC) with a multi-eyelet drainage zone showed significantly lower pressure peaks, with over 4 times lower peak intensity, thus inducing far less extensive microtraumas. Limiting or even eliminating mucosal suction and resulting tissue microtrauma may contribute to safer catheterizations in vivo and increased patient comfort and compliance.
摘要：
利用常规孔眼导管(CEC)进行膀胱引流的间歇性导管插入术(IC)长期以来一直是护理标准。然而,当下尿路组织靠近孔眼时，经常发生粘膜抽吸，导致微创伤.这项研究调查了用具有多个微孔的排水区代替常规孔眼的影响，分布压力在一个更大的区域。较低的压力限制了周围组织吸入这些微孔，显着减少组织微创伤。使用体外模型复制膀胱的腹内压力状况，在引流期间测量导管内压力.当粘膜抽吸发生时，记录导管内图像.随后受影响的组织样品进行组织学研究。发现由粘膜抽吸引起的负压峰值对于CEC非常高，导致膀胱尿路上皮脱落和尿路上皮屏障破坏。然而,具有多孔眼引流区的微孔区导管（MHZC）显示出明显较低的压力峰值，峰值强度低4倍以上，因此诱发的微创伤要小得多。限制或甚至消除粘膜抽吸和导致的组织微创伤可以有助于在体内更安全的导管插入和增加患者的舒适度和顺应性。
