摘要
目的探讨膀胱自扩大手术治疗高反射性神经原性膀胱的方法及疗效。方法6例患者,男5例,女1例,年龄5～36岁,平均28岁。尿动力学检查显示6例均为膀胱反射亢进,逼尿肌括约肌协同失调。病程5～10年,平均6年。对6例患者的手术方法,手术前后膀胱容量,肾功能以及临床症状进行回顾分析。结果手术时间100～180min,平均120min。安全膀胱容量术前(182±52)ml,术后3个月(315±65)ml,术后10个月(420±105)ml,手术前后比较差异有统计学意义(P<0.01)。术后导尿间歇平均4h(3～5h),术前5例尿失禁患者尿失禁消失4例,1例经口服抗胆碱药物后症状明显改善。术前4例肾功能异常者3例恢复正常,1例改善。结论膀胱自扩大术结合清洁间歇自家导尿治疗高反射性小容量膀胱是一种简便,可靠的方法。
Objective To evaluate the technique and effect of bladder autoaugmentation for the treatment of hyperreflexia neurogenic bladder. Methods Six patients (5 males and 1 female) underwent bladder autoaugmentation.The patients' mean age at operation was 28 years (range,5-36 years). Urodynamic examination showed hyperreflexia of the bladder and dyssynergia of detrusor sphincter in all the 6 patients.The mean disease course was 6 years (range,5-10 years).The mean follow-up was 10 months (range,6-24 months).The surgical techniques,pre- and post-operative bladder capacity and renal functions of the 6 patients were analyzed retrospectively. Results The mean operative time was 120 min (range,100-180 min).The pre-operative safe bladder capacity was (182±52)ml,and it increased to (315±65)ml (P<0.01) and (420±105)ml (P<0.01),respectively,3 and 10 months after operation.The average interval between two self-catheterization was 4 h (range,3-5 h).Among 5 patients with incontinence,complete continence on clean intermittent catheterization was achieved in 4,and improved markedly in 1 by adjuvant oral anticholinergic drugs.In 4 patients with abnormal renal function,it became normal in 3 and improved significantly in 1 after operation. Conclusions Bladder autoaugmentation with clean intermittent self-catheterization for the treatment of hyperreflexia, small volume neurogenic bladder is simple and reliable.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2005年第6期412-414,共3页
Chinese Journal of Urology
