臨床泌尿器科73巻4号

2019年04月発行

増刊号特集 泌尿器科周術期パーフェクト管理 カテーテル・ストーマ管理

周術期の尿道カテーテル・膀胱瘻・腎瘻の管理

著者： 斎藤恵介¹

所属機関： ¹順天堂大学医学部附属静岡病院泌尿器科

ページ範囲：P.276 - P.279

Point

◆泌尿器科手術後の尿道カテーテル留置は，創傷治癒，血尿管理，ドレナージなど，使用目的は多岐にわたる．それぞれの術式の理解と術後合併症を熟知し，適切なカテーテルの選択と管理が必要となる．

◆膀胱瘻および腎瘻造設は，可能な限りmaximum barrier precautionsにて行う．

参考文献

1） Warren JW : Nosocomial urinary tract infection. In : Mandel GL, Bennett JE, and Dolin R （eds） : Principle and Practice op Infectious Disease 5th ed. pp3028-3039, Churchill Livingstone, Philadelphia, 2000

2） Peloquin CA, Cumbo TJ and Schentag JJ : Kinetics and dynamics of tobramycin action in patients with bacteriuria given single doses. Antimicrob Agents Chemother 35 : 1191-1195, 1991

3） Kumazawa J and Matumoto T : The dipstick test in the diagnosis of UTI and the effect of pretreatment catheter exchange in catheter-associated UTI. Infection 20 （Suppl 3） : S157-159, 1992

4） Daifuku R and Stamm WE : Association of rectal and urethral colonization with urinary tract infection in patients with indwelling catheters. JANA 252 : 2028-2030, 1984

5） Garibaldi RA, Burke JP, Britt MR, et al : Meatal colonaization and catheter-associated bacteriuria. N Engl J Med 303 : 316-318, 1980

6） Burke JP, Garibaldi RA, Britt MR, et al : Prevention of catheter-associated urinary tract infections : Efficacy of daily meatal care regimens. Am J Med 70 : 655-658, 1981

7） Classen DC, Larsen RA, Burke JP, et al : Daily meatal care for prevention of catheter-associated bacteriuria : results using frequent applications of polyantibiotic cream. Infect Control Hospepdemiol 12 : 157-162, 1991

8） Muncie HL Jr, Hoopes Jm, Damron DJ, et al : Once-daily irrigation of long-term urethral catheters with normal saline : Lack of benefit. Arch Intern Med 149 : 441-443, 1989

9） Warren JW, Platt R, Thomas RJ, et al : Antibiotic irrigation and catheter-associated urinariy-tract infections. N Engl J Med 299 : 570-573, 1978

10） Bastable JR, Peel RN, Birch DM, et al : Contimuous irribgation of the bladder after prostatectomy : its effect on post-prostatectomy infection. Brit J Urol 49 : 689-693, 1977

11） Gillespie WA, Simpson RA, Jones JE, et al : Dose the addition of disinfectant to urine drainage bags prevent infection in catheterized patients? Lancet 1 : 1037-1039, 1983

12） Wong ES : Guideline for Prevention of Catheter-associated Urinary Tract Infections. Am J Infect Control 11 : 28-36, 1983

13） Marinella MA, Pierson C and Chenoweth C : The stethoscope. A potential source of nosocomial infection? Arch Intern Med 157 : 786-790, 1997

14） Farnell S : Are tympanic thermometers a source of cross-infection? Nurs Times 101 : 62-63, 2005

15） McPhail MJ, Abu-Hilal M and Johnson CD : A meta-analysis comparing suprapubic and transurethral catheterization for bladder drainage after abdominal surgery. Br J Surg 93 : 1038-1044, 2006

16） Tenke P, Kovacs B, Bjerklund Johansen TE, et al : European and Asian guidelines on management and prevention of catheter-associated urinary tract infections. Int J Antimicrob Agents 31（Suppl 1） : S68-78, 2008

17） Stables DP, Ginsberg NJ and Johnson ML : Percutaneous nephrostomy : a series and review of the literature. AJR Am J Roentgenol 130 : 75-82, 1978

18） Radecka E and Magnusson A : Complications associated with percutaneous nephrostomies. A retrospective study. Acta Radiol 45 : 184-188, 2004

19） Ramchandani P, Cardella JF, Grassi CJ, et al : Quality improvement guidelines for percutaneous nephrostomy. J Vasc Interv Radiol 14 : S277-281, 2003

20） 日本泌尿器科学会（編） : 泌尿器科領域における周術期感染予防ガイドライン2015. メディカルレビュー社, 東京, 2015

21） Matsumoto T, Kiyota H, Matsukawa M, et al : Japanese guidelines for prevention of perioperative infections in urological field. Int J Urol 14 : 890-909, 2007