脊髓损伤者之排尿照护课件

按一下以編輯母片標題樣式,*,按一下以編輯母片,第二層,第三層,第四層,第五層,排尿障礙治療中心 版權所有,脊髓損傷者之排尿照護,郭漢崇 醫師,慈濟醫院 排尿障礙治療中心,脊髓損傷者之排尿照護郭漢崇 醫師,脊髓損傷者常見的泌尿系統問題,尿失禁,排尿困難,反覆尿路感染,脊髓損傷者常見的泌尿系統問題尿失禁,常見的泌尿系統併發症,尿路感染腎盂發炎或膀胱發炎,尿路結石腎結石及膀胱結石,腎水腫膀胱漲尿或尿液逆流,腎功能衰竭,常見的泌尿系統併發症尿路感染腎盂發炎或膀胱發炎,Late complications in 704 SCI,頸髓脊髓損傷,胸髓脊髓損傷,腰髓脊髓損傷,薦髓及以下脊髓損傷,總計,完全,不完全,完全,不完全,完全,不完全,完全,不完全,完全沒有,44,60,43,16,18,44,3,3,231,(32.8%),反覆尿路感染,51,37,78,24,27,22,0,4,243,(34.5%),尿路結石,11,10,38,15,10,5,0,1,90,(12.8%),腎臟水腫,16,6,21,5,2,8,0,4,62,(8.8%),輸尿管逆流,14,7,19,6,8,0,0,1,55,(7.8%),腎衰竭,6,5,8,2,2,1,1,0,25,(3.6%),Late complications in 704 SCI頸,脊髓損傷者之排尿處置,自行反射性排尿,下腹敲尿或誘尿,使用腹壓或以手壓迫排尿,留置導尿管,尿完全失禁以尿套或尿布處置,脊髓損傷者之排尿處置自行反射性排尿,脊髓损伤者之排尿照护课件,留置導尿管的後遺症,尿路感染,膀胱結石,膀胱萎縮,尿道廔管,輸尿管尿液逆流,留置導尿管的後遺症尿路感染,我是不是高危險群 SCI病友?,高位脊髓損傷,具有高壓性排尿者,大量殘尿,反覆性尿路感染,具有輸尿管尿液逆流,我是不是高危險群 SCI病友?高位脊髓損傷,如何避免尿路感染?,儘量排空膀胱壓尿、敲尿、導尿,定期更換導尿管,多喝水及吃酸性食物,定期檢查排尿情形及排尿壓力,如何避免尿路感染?儘量排空膀胱壓尿、敲尿、導尿,如何保護腎臟?,多喝水、多吃酸性食物,常常將尿液排空,適當休息及運動,定期更換導尿管,如何保護腎臟?多喝水、多吃酸性食物,尿失禁能不能改善?,口服抗膽鹼藥物,膀胱內灌注紅辣椒素或RTX,逼尿肌注射肉毒桿菌毒素,膀胱擴大整形術,尿失禁能不能改善?口服抗膽鹼藥物,Initial CMG Tracing after RTX,Initial CMG Tracing after RTX,Urodynamic tracings before,during and after resiniferatoxin,Urodynamic tracings before,du,Botulinum Toxin Detrusor Injection for Detrusor Hyperreflexia,Botulinum Toxin Detrusor Injec,Botulinum A toxin Detrusor Injection for Detrusor Hyperreflexia,Botulinum A toxin Detrusor Inj,Technique of augmentation cystoplasty,Technique of augmentation cys,Surgical results after augmentation cystoplasty,Surgical results after augment,能不能拔除導尿管?,低位脊髓損傷膀胱擴大整形術,高位脊髓損傷肉毒桿菌毒素注射,尿液逆流腸道整型及抗逆流裝置,尿道外括約肌切開術,可禁尿式膀胱造廔,能不能拔除導尿管?低位脊髓損傷膀胱擴大整形術,肉毒桿菌,素,注射尿道外括約肌,肉毒桿菌素注射尿道外括約肌,Botulinum A Toxin Injection in Woman,Botulinum A Toxin Injection in,Cystoscopic Urethral Injection in Men,*,*,*,*,Cystoscopic Urethral Injection,Reduction of voiding pressure after Botulinum A Toxin,Reduction of voiding pressure,Reduced abdominal voiding pressure after botulinum toxin,Reduced abdominal voiding pres,Reduction of MUCP after Botulinum A Toxin,Reduction of MUCP after Botuli,Bladder autoaugmenttion,Bladder autoaugmenttion,Anti-reflux afferent nipple valve,Anti-reflux afferent nipple va,Sonography of Kock pouch,Sonography of Kock pouch,Degeneration of intestinal wall in Urinary reservoir,Degeneration of intestinal wal,脊髓损伤者之排尿照护课件,Reduced Intravesical pressure after external sphincterotomy,Reduced Intravesical pressure,Reduction in MUCP afterExternal sphincterotomy,Reduction in MUCP afterExtern,Implantation of a urethral stent,Implantation of a urethral ste,Artificial Urethral Sphincter,Artificial Urethral Sphincter,Thank you for your attention,Thank you for your attention,