外傷性脊髄障害における排尿障害

Urinary disturbances due to traumatic spinal cord injuries

はじめに

　外傷性脊髄障害が発生すると，その瞬間から膀胱麻痺が始まる。脊髄障害，換言すれば横断麻痺の程度によって膀胱麻痺の回復はさまざまであるが，大部分の症例は生涯膀胱機能のアンバランスを背負うことになる。

　尿路における尿の産生と輸送は，脊髄ショックの短時間を除くと一刻も休みなく続けられるから，その排除管理を怠るとたちまち尿の停滞と尿路への過伸展をもたらす。

Summary

Vesical dysfunction due to spinal cord injuries was discussed.

Imbalance between detrusor and urethral pres-sure is the main cause of urinary retention in the acute stage of spinal shock.

Urinary retention should be treated mainly by aseptic intermittent catheterization to prevent overdistention and infection of the urinary bladder.

If needed, indwelling catheterization must be atraumatic and aseptic with the non-touch closed system.

Bladder training should be begun as early as possible according to the recovery of paralysed muscles.