背景:如果需要,患者/护理人员使用清洁间歇性自我导管插入术(CISC或ISC)来排空膀胱。有时从膀胱出来的尿道腔阻塞;有时,膀胱(逼尿肌)肌肉本身或支配膀胱的自主神经运动神经受损,导致逼尿肌无法工作,导致膀胱不能充分排空。关于CISC的适应症和时机尚未达成共识。本文旨在就此主题提供多学科共识。
结论:显然,每个患者都需要单独考虑,记住要考虑的症状和调查。我们强调考虑术语膀胱排尿效率(BVE)的重要性。一组可能发现CISC有帮助的患者是患有神经系统疾病的患者;这些包括脊髓损伤患者,多发性硬化症,帕金森,还有一种叫做马尾的病症.有时膀胱问题可以用抗胆碱能药物治疗,和其他人可以用肉毒杆菌治疗。这些可能会导致膀胱根本不会排空,这对泄漏有好处,但需要自我导管插入以排空膀胱。在过去,医院使用永久性导管,称为“留置”或“耻骨上”导管。这些可能有副作用,包括感染,石头,和痛苦。ForCISC,一次性导管是患者的最佳选择,因为它们有不同的尺寸和风格来提供个性化的护理。总之,我们希望医院单独考虑每个患者,而不是对这些患者使用一般的“一刀切”膀胱功能。
BACKGROUND: Clean intermittent self-catheterisation (CISC or ISC) is used by patients/carers to empty the bladder if needed. Sometimes the urethral lumen leading out of the bladder is blocked; sometimes, the bladder (detrusor) muscle itself or the autonomic motor nerves innervating the bladder are damaged, resulting in a failure of the detrusor muscle to work, leading to a failure of the bladder being able to empty adequately. Prior
consensus as to the indications and timing of CISC has yet to be provided. This article aims to provide a multidisciplinary
consensus view on this subject.
CONCLUSIONS: It is evident that every patient needs to be considered individually, bearing in mind the symptoms and investigations to be considered. We emphasise the importance of considering the term Bladder Voiding Efficiency (BVE). One group of patients who might find CISC helpful are those with a neurological disorder; these include spinal injury patients, multiple sclerosis, Parkinson\'s, and a condition called cauda equina. Sometimes bladder problems are treated with anticholinergics, and others may be treated with Botox. These may cause the bladder not to empty at all, which is good for leaks but needs self-catheterisation to empty the bladder. In the past, hospitals used a permanent catheter called an \'indwelling\' or a \'suprapubic\' catheter. These can have side effects, including infections, stones, and pain. For CISC, disposable catheters are the best option for patients as they come in different sizes and styles to provide individualised care. In conclusion, we would like hospitals to consider each patient separately and not use a general \'one-size-fits-all\' bladder function for these patients.