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导尿管的并发症及预防策略

Author
Anthony J Schaeffer, MD
Section Editor
Jerome P Richie, MD, FACS
Deputy Editor
Kathryn A Collins, MD, PhD, FACS
Translators
陈跃东, 主任医师

引言

导尿管用于尿液引流或用于收集尿液标本以行相关检测。许多临床情况适合留置导尿管(表 1)，但也经常出现没有适当适应证却使用导尿管或者导尿管留置过久等问题[1]。每日评估是否需要持续留置导尿管并在不需要时拔出导尿管，是减少并发症的关键。

本专题将讨论与导尿管使用相关的并发症。放置导尿管的适应证、导尿管的类型及管理，将在别处详细讨论。 (参见“导尿管的放置与管理”)

一般并发症

细菌尿和泌尿道感染 — 导尿管留置超过1周的患者尿液中几乎普遍存在细菌。细菌尿的发生率依导尿管类型及持续使用时间的不同而有差异。细菌尿的评估和导管相关泌尿道感染的诊断将在别处详细讨论。 (参见“成人导管相关泌尿道感染”，关于‘无症状性菌尿’一节和“成人导管相关泌尿道感染”，关于‘诊断’一节)

长期留置导尿管导致的反复泌尿道感染可引起急性或慢性肾盂肾炎或膀胱癌。 (参见“膀胱尿路上皮(移行细胞)癌的流行病学和危险因素”和“膀胱非尿路上皮癌”)

附睾炎 — 任何类型的尿道器械均可能引起附睾炎，但罕见情况下可能感染播散到睾丸并引起睾丸炎[2]。 (参见“成人阴囊急症的评估”)

             

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Literature review current through: 2017-06 . | This topic last updated: 2017-04-11.
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