Urinary catheters: history, current status, adverse events and research agenda.
Urinary catheters: history, current status, adverse events and research agenda.
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DOI：
10.3109/03091902.2015.1085600
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发表时间：
2015
影响因子：
--
通讯作者：
Wells PN
中科院分区：
文献类型：
--
作者：
Feneley RC;Hopley IB;Wells PN
3500多年来，人们一直使用导尿管来排空膀胱。对于膀胱功能受损且方法可行的人来说，清洁的间歇自我导尿是最佳的方法。对于那些需要留置导尿管的患者，无论是短期还是长期，自保留式Foley导尿管总是被使用，自其近80年前推出以来一直如此，尽管这种导尿管可能导致细菌定植，复发性和慢性感染，膀胱结石和败血症，损害肾脏，膀胱和尿道，并有助于抗生素耐药性的发展。在医疗、社会和经济资源方面，由于Foley导尿管的使用，尿潴留和尿失禁的负担是巨大的。在英国，使用Foley导尿管造成的伤害每年花费国民健康服务10 - 25亿英镑，造成2100人死亡。因此，迫切需要开发一种替代的留置导管系统。研究议程是使新型导尿管易于安全地插入，无论是尿道还是耻骨上，在膀胱中可靠地保留，必要时可以轻松安全地取出，通过低压填充和完全排空而不损坏膀胱来模仿自然生理，并具有适合所有用户的控制机制。
For more than 3500 years, urinary catheters have been used to drain the bladder when it fails to empty. For people with impaired bladder function and for whom the method is feasible, clean intermittent self-catheterization is the optimal procedure. For those who require an indwelling catheter, whether short- or long-term, the self-retaining Foley catheter is invariably used, as it has been since its introduction nearly 80 years ago, despite the fact that this catheter can cause bacterial colonization, recurrent and chronic infections, bladder stones and septicaemia, damage to the kidneys, the bladder and the urethra, and contribute to the development of antibiotic resistance. In terms of medical, social and economic resources, the burden of urinary retention and incontinence, aggravated by the use of the Foley catheter, is huge. In the UK, the harm resulting from the use of the Foley catheter costs the National Health Service between £1.0–2.5 billion and accounts for ∼2100 deaths per year. Therefore, there is an urgent need for the development of an alternative indwelling catheter system. The research agenda is for the new catheter to be easy and safe to insert, either urethrally or suprapubically, to be retained reliably in the bladder and to be withdrawn easily and safely when necessary, to mimic natural physiology by filling at low pressure and emptying completely without damage to the bladder, and to have control mechanisms appropriate for all users.