A Comparison Of The Influence Of Intermittent Clamping And Open Draiage On The Bladder Function And Urinary Infection In Short-term Indwelling Urethral Catheterization Rabbits

Objective This experimental study aims to explore the influence of short-term indwelling urethral catheterization on the bladder function and urinary infection on rabbits and to compare the effectiveness of opening drainage and intermittent clamping on bladder function decrease and urinary infection caused by short-term indwelling urethral catheterization, thus to determine the necessity and safety of intermittent clamping in short-term indwelling urethral catheterization and provide scientific evidence for clinical nursing practice.Methods22healthy rabbits were randomly divided into2groups, which were the normal control group(n=2), the experimental group(n=20), then the experimental group was subdivided into the intermittent clamping group(n=10) and the opening drainage group(n=10). In the opening drainage group, the rabbits were performed3-day indwelling urethral catheterization, in which no clamping was conducted. In the intermittent clamping group, the rabbits were performed3-day indwelling urethral catheterization which consisted of15-minute opening followed by2-hour clamping circularly after2-day opening drainage. Midstream urine of the intermittent clamping group and the opening drainage was collected before removal of the urethral catheters to measure the urinary infection rate. Urodynamics test was performed in the intermittent clamping group and the opening drainage group before catheterization, right before removal of catheters,4and7days after removal, to explore the influence of short-term indwelling urethral catheterization on bladder function and compare the effects of intermittent clamping group and the opening drainage group on bladder function recovery after short-term indwelling urethral catheterization. To check out the changes in structure of the bladder by hematoxylineosin(HE) staining,3rabbits was picked at the end of catheterization and post-removal day7from intermittent clamping group and the opening drainage group respectively by draw method to observe the influence of short-term indwelling urethral catheterization on rabbits bladder issue, and compare the effects of intermittent clamping and the opening drainage on bladder tissue structure after short-term indwelling urethral catheterization.Results the results of within group comparison showed that after the3-day indwelling urethral catheterization,no matter in the intermittent clamping group or the opening drainage group, the maximum detrusor pressure, bladder capacity and bladder compliance were significantly lower than those before catheterization (P≤0.05), at post-catheterization day4, the bladder compliance recovered to the level of the pre-test, however the maximum detrusor pressure and the bladder capacity of both groups did not recover compared to the removal day (P>0.05),at post-removal day7, the maximum detrusor pressure, bladder capacity and bladder complience of the two groups had no difference from pre-catheterization (P>0.05) the results of between-group comparison showed that after the catheterization, no matter at removal day or post-removal day4and7, the maximum detrusor pressure, bladder capacity and bladder compliance all had no significant difference between the two groups (P>0.05); after3-day indwelling urethral catheterization,6rabbits were afflicted with the urinary tract infection in the intermittent clamping group,4rabbits were afflicted with the urinary tract infection in the opening drainage group, there was no statisticall difference between the two groups (P>0.05). The observetion of the HE stained section showed, right after the removal of catheters, the musle bundle of the intermittent clamping group and the opening drainage group all ranged confusedly campared to the normal rabbits, however at post-removal day7, the bladder structure of the two groups indicated no obvious difference with the normal rabbits. Both on removal day and post-removal day7, no obvious difference of bladder structure was found in the two groups.Conclusions3-day indwelling urinary catheterization could cause damage to the bladder function and baldder structure in rabbits, and all the indexes of the bladder function did not recover to normal level until7days after removal. There was no statistical difference between the intermittent clamping group and the opening drainage group in the influence of bladder function and urinary tract infection rate, and no obvious difference of bladder structure was found in the two groups. In the clinical care of short-term indwelling urinary catheterization patients, intermittent clamping could be avoided to reduce the workload of nurses, and eliminate the potential risks.