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| 發表人 | 討論主題 | 發表時間 | 討論數 |
| 王炯珵 | 臨床評估生物膠捲偵測導尿管內結晶的形成 | 2007/3/16 上午 11:26:04 | 0 |
| 原 文 | 題 目 | clinical assessment of the performance of a sensor to detect crystalline biofilm formation on indwelling bladder catheters. |
| 作 者 | Stickler DJ | |
| 出 處 | BJU Int. | |
| 出版日期 | 2006 Dec;98(6):1244-9. | |
| 評 論 |
對於許多需要長期照顧的老人，放置尿管後發生結晶導致尿管阻塞是很常見的併發症，這問題發生的時間通常很難預測，萬一發生後病患會尿不出來需要緊急處理，如何防患未然，來自英國Wales和Bristol的研究團隊有答案。 尿管會有結晶產生的主要原因是由於分解尿素的細菌（Urease-producing organism）所產生的，其中以Proteus mirabilis最常見。這些細菌會聚集在尿管上，形成生物膠捲（Biofilm），使用cellulose acetate/bromothymol blue做成的感應器（sensor）就可以知道有沒有細菌感染。 結果顯示，20位受試者中，15位有P. mirabilis感染者，顏色變成深藍色至黑色，5位沒有P. mirabilis感染者，顏色維持金黃色至棕色，尿液中的pH值不會影響顏色的變化，15位感染者，尿管內都發現有結晶，同時在發現顏色改變平均12天後有12位的尿管阻塞了。 使用生物膠捲感測器，可以有效知道現在有無細菌感染和預知未來尿管的通暢性，一個很簡單的設計就可以增進老人的健康，泌尿科相關的醫學工程，很值得大家一起來研究。 |
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| abstract |
OBJECTIVES: To test the ability of a sensor developed to signal infection by the organisms that generate the crystalline biofilms that encrust catheters, to give an early warning that encrustation was occurring on patients'' catheters, as the care of many patients undergoing long-term bladder catheterization is complicated by the encrustation and blockage of their catheters. PATIENTS AND METHODS: Twenty patients were followed prospectively for the lifetime of one of their catheters. Sensors based on cellulose acetate/bromothymol blue were placed in the urine-collection bags, which were changed as usual at weekly intervals. The bacteriology was assessed and pH determined weekly on urine samples. Photographic records were made of the sensors twice weekly. On removal, each catheter was examined for encrustation and blockage. RESULTS: Proteus mirabilis was not isolated from five patients and in these cases the sensor colour remained golden-yellow to brown. The catheters drained for the scheduled period and showed no signs of encrustation. By contrast, the sensors turned dark blue/black in the urine of all 15 patients infected with P. mirabilis. All these patients'' catheters were encrusted and in 12 the catheters blocked. The mean interval between the sensor signalling and the catheter blocking was 12 days. CONCLUSION: The cellulose acetate/bromothymol blue sensors placed in the urine collection bags are capable of signalling infection by P. mirabilis. They also signal the early stages of catheter encrustation and allow catheter replacement in ample time to avoid the clinical crises and emergency referrals caused by catheter blockage. |
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