膀胱用超音波画像診断装置を用いた膀胱内尿量連続測定による術後尿道カテーテル留置中患者の尿流出状況の実態

Actual Condition of Urine Outflow in Postoperative Patients with Indwelling Urinary Catheter by the Continuous Measurement of Intravesical Urine Volume Using Ultrasound Bladder Scanner

要旨

　目的：術後尿道カテーテルを留置している患者の膀胱内尿量を連続測定し尿流出状況の実態を明らかにする．

　方法：泌尿器・消化器・内分泌手術後に尿道カテーテルを留置している患者を対象に，手術後から翌朝まで膀胱用超音波画像診断装置を装着し，膀胱内尿量を1分毎に連続測定した．なお膀胱内尿量100ml以上を「尿流出停滞」と定義した．

　結果：患者23名中16名を分析対象とした．そのうち「尿流出停滞」を認めた患者は7名（43.8％）であった．膀胱内尿量最高値は中央値（四分位範囲）78（51，143）mlで，範囲は34〜193mlであった．尿流出停滞を認めた患者7名の尿流出停滞時間は中央値（四分位範囲）24（2，48）分で，範囲は2〜61分であった．

　結論：術後尿道カテーテル留置中患者の半数近く（43.8％）に一時的な尿流出停滞を認め，停滞時の最高膀胱内尿量は193mlであった．

　Aim: This study aimed to clarify the actual condition of urine outflow by the continuous measurement of intravesical urine volume in postoperative patients with indwelling urinary catheter.

　Methods: This study included patients with temporary indwelling urinary catheters after a urinary, a digestive, or an endocrine surgery. The patients were equipped with an ultrasound bladder scanner, and their intravesical urine volume was measured at 1-min intervals from after the surgery to the next morning. An intravesical urine volume of ≥ 100 ml was defined as “stagnation of urine outflow.”

　Results: Of the 23 patients, 16 were included in the analysis, and seven patients (43.8%) presented with stagnation of urine outflow. The median (interquartile range) of maximum intravesical urine volume was 78 ml (51, 143), with a range of 34 -193 ml. The median (interquartile range) of urinary outflow stagnation time was 24 min (2, 48), with a range of 2 - 61 min, in seven patients with stagnation of urine outflow.

　Conclusion: Nearly half (43.8%) of the postoperative patients with indwelling urinary catheter presented with temporary stagnation of urine outflow, and the maximum value of intravesical urine volume during stagnation of urine outflow was 193 ml.