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首页> 外文期刊>Advances in urology >Use of Flexible Cystoscopy to Insert a Foley Catheter over a Guide Wire in Spinal Cord Injury Patients: Special Precautions to be Observed
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Use of Flexible Cystoscopy to Insert a Foley Catheter over a Guide Wire in Spinal Cord Injury Patients: Special Precautions to be Observed

机译：灵活的膀胱镜检查法在脊髓损伤患者的导丝上插入Foley导管：应注意的特殊预防措施

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摘要

When urethral catheterisation is difficult or impossible in spinal cord injury patients, flexible cystoscopy and urethral catheterisa-tion over a guide wire can be performed on the bedside, thus obviating the need for emergency suprapubic cystostomy. Spinal cord injury patients, who undergo flexible cystoscopy and urethral catheterisation over a guide wire, may develop potentially serious complications. (1) Persons with lesion above T-6 are susceptible to develop autonomic dysreflexia during cystoscopy and urethral catheterisation over a guide wire; nifedipine 5-10 milligrams may be administered sublingually just prior to the procedure to prevent autonomic dysreflexia. (2) Spinal cord injury patients are at increased risk for getting urine infections as compared to able-bodied individuals. Therefore, antibiotics should be given to patients who get haematuria or urethral bleeding following urethral catheterisation over a guide wire. (3) Some spinal cord injury patients may have a small capacity bladder; in these patients, the guide wire, which is introduced into the urinary bladder, may fold upon itself with the tip of guide wire entering the urethra. If this complication is not recognised and a catheter is inserted over the guide wire, the Foley catheter will then be misplaced in urethra despite using cystoscopy and guide wire.
机译：当在脊髓损伤患者中很难或不可能进行尿道插管时，可以在床旁进行柔性膀胱镜检查和通过导尿管进行尿道插管，从而无需进行紧急耻骨上膀胱造瘘术。接受柔性膀胱镜检查并在导丝上进行尿道导管插入术的脊髓损伤患者可能会出现潜在的严重并发症。 （1）T-6以上病变的人在膀胱镜检查和导尿管导尿期间易发生自主神经反射不良;可以在手术前舌下施用硝苯地平5-10毫克，以防止自主神经反射不良。 （2）与健壮的个体相比，脊髓损伤的患者发生尿液感染的风险更高。因此，在导丝经导尿管插管后出现血尿或尿道出血的患者应使用抗生素。 （3）部分脊髓损伤患者的膀胱容量可能较小;在这些患者中，导入导尿管的导丝可能会折叠，导丝尖端会进入尿道。如果未发现这种并发症，并且将导管插入导丝上，则尽管使用了膀胱镜和导丝，但Foley导管仍会在尿道中错位。

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