新型留置導尿管固定裝置與傳統裝置之比較

A Novel Indwelling Bladder Catheter Securing Device Compared to Traditional Devices

目的：評估我們的新型留置導尿管固定裝置和榮總留置導尿管固定裝置及紙膠帶。方法：在台北榮民總醫院泌尿部使用的榮總留置導尿管固定裝置是由低過敏黏著性固定伸縮膠布、布膠及一條長紗條所組成。以榮總留置導尿管固定裝置為基礎，我們發展一種由低過敏黏著性固定伸縮膠布及兩條棉帶所組成的新型留置導尿管固定裝置，為了測試這個新型留置導尿管固定裝置，我們招募了39個在本院慢性呼吸病房及呼吸加護病房有留置導尿管的病人進入本研究。我們使用問卷來比較這三種留置導尿管固定方法的留置導尿管固定效果及皮膚過敏反應。結果：在這些病人中，有13個及4個病人分別對紙膠帶及榮總留置導尿管固定裝置有過敏反應，沒有病人對新型留置導尿管固定裝置有過敏反應。這種新型留置導尿管固定裝置和榮總留置導尿管固定裝置及紙膠帶比較在各方面都比較好（P<0.001）。結論：這種新型留置導尿管固定裝置比榮總留置導尿管固定裝置及紙膠帶好。這種新型留置導尿管固定裝置可以很容易由照顧者自行製作出來、比較便宜且可以把留置導尿管固定得更牢也具有較低的過敏率。

Objectives. To evaluate our novel indwelling bladder catheter securing device against the Taipei Veterans General Hospital (VGH) indwelling bladder catheter securing device and the paper tape method. Methods. The VGH indwelling bladder catheter securing device used in Department of Urology, Taipei VGH, Taiwan consists of a low-allergy adhesive retention sheet, cloth tape, and a long gauze tape. Based on this VGH device, we developed a novel approach to fixation using a low-allergy adhesive retention sheet and two long cotton straps. To test it, we enrolled 39 patients with indwelling bladder catheters from our chronic respiratory ward and intensive respiratory ward in this study. We used questionnaires to compare the catheter fixation effects and the skin allergic reactions among the three catheter fixation methods. Results. Among the patients, 13, 4, and 0 were allergic to the paper tape, VGH device, and novel device, respectively. The responses to the novel device were more positive than to the VGH device and paper tape in all aspects (p<0.001). Conclusion. Our low-allergy adhesive retention sheet plus cotton straps approach to securing the indwelling bladder catheters was superior to the VGH device and paper tape. The patients’ caregivers can easily construct our device with relatively low cost materials and affix the catheter with higher stability and a lower risk of skin allergies.