保育器収容児の採尿方法の検討 : スポンジを使用した腹臥位での採尿方法 <報告>

保育器収容児を管理する際には,呼吸抑制が起こりにくいことや胃残乳量が少ないことなどの利点から腹臥位で保育されることが多く,採尿を行う場合に必要量の検体を採取できないことが少なくない。また,発赤などの皮膚トラブルを伴うこともある。本研究では,スポンジを用いて採尿バッグ内に空間を設ける新たな採尿方法(B法)を考案し,その有用性について従来の方法(A法)と比較検討した。その結果,B法はA法に比べて男児・女児ともに有意(男児・女児ともP<0.05)に高い採尿率を示した。尿もれの原因については,ほとんどの症例が採尿バッグの剥がれやズレによるものであったが,B法はA法に比べて尿もれが有意(P<0.01)に少なく,さらに採尿バッグのズレを容易に直すことが可能であり,このことが採尿率の上昇につながったと考えられた。また,B法では採尿バッグ内に空間を設けているので,尿が採尿バッグの底に流れにくい場合でも,A法に比べて尿が溜まりやすく,腹臥位でも高い採尿率が得られたものと思われた。B法において,発赤などの皮膚トラブルが1例もみられなかったことから,スポンジの使用は皮膚の発赤予防に効果があったといえる。今後は,採尿バッグの固定方法と尿が採尿バッグの底ヘスムーズに流れて溜まるような工夫をB法に加えるとともに,より低体重児に対する有用性を検討したい。

Generally, premature infants are placed in prone position in the incubators so that such advantages may be offered as the minimized risk of respiratory inhibition and the reduced volume of residual milk in stomach. On the contrary, this body position not only hampers the successful collection of a necessary volume of urine in many cases but also may cause dermatitis. e.g., rubor, in some cases. In this study, we developed a new urine collection method (hereafter. simply referred to as Method B), in which a space was left around a piece of sponge in a urine collecting bag. and compared it with the conventional method (hereafter. simply referred to as Method A) for evaluating its usefulness. The comparison revealed that the rates of urine co1lection for both male and female infant groups were significantly higher (Pc0.05 for both groups) in Method B than those in Method A. Urine leakage was observed when the urine collecting bag was detached from the infant or dislocated from its original position in most cases. In Method B. the number of cases of urine leakage. was significantly less (P<0.01) than that in Method A. and the urine collecting bag could be easily replaced in position. For this reason. it may be reasonably considered that Method B improved the rates of urine collection. In addition. it was suggested that Method B with a space left around a piece of sponge in the urine collecting bag facilitated easier urine collection into the bottom of the bag compared with Method A even if a urine flow toward the bottom was obstructed, resulting in higher rates of urine collection even in prone position. The fact that no dermatitis was observed. e.g.. rubor. in Method B demonstrated that the use of a piece of sponge in the urine collecting bag also had an effect on prevention of dermatitis. We will make a further study on the improved version of Method B, in which a new technique for attaching the bag firmly to the infants and forcing a urine flow into the bottom of the bag with no obstruction is to be developed. ...