中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2009年
8期
550-551
,共2页
李炎唐%董隽%年秀珍%初善芝%张旭%董宝玮%唐杰
李炎唐%董雋%年秀珍%初善芝%張旭%董寶瑋%唐傑
리염당%동준%년수진%초선지%장욱%동보위%당걸
膀胱,神经原性%排尿障碍%外科手术,选择性
膀胱,神經原性%排尿障礙%外科手術,選擇性
방광,신경원성%배뇨장애%외과수술,선택성
Bladder,neurogenic%Urination disorders%Surgical procedures,elective
目的 总结经尿道手术治疗神经性排尿障碍的疗效及适应证.方法 神经性排尿功能障碍患者41例.男13例,女28例.年龄12~43岁,平均27岁.其中骶椎裂36例、骶脊膜膨出术后2例、骶神经瘤切除术后1例、腰椎外伤术后2例.临床表现为排尿困难、尿线细.B超检查提示膀胱残余尿及双肾输尿管积水,尿动力学检查提示神经原性膀胱.手术采用局麻,女性患者在5、6、7点电切膀胱颈至环状纤维;男性患者在11、1点垂直部分切断外括约肌.结果 41例均获随访,平均随访85(2~252)个月.手术成功36例(88%),患者排尿通畅,尿流率增加>10 ml/s,肾输尿管积水减少或消失.无效5例(12%).结论 经尿道电切治疗骶神经损伤所致下尿路排尿功能障碍方法简便易行、费用低、效果好.
目的 總結經尿道手術治療神經性排尿障礙的療效及適應證.方法 神經性排尿功能障礙患者41例.男13例,女28例.年齡12~43歲,平均27歲.其中骶椎裂36例、骶脊膜膨齣術後2例、骶神經瘤切除術後1例、腰椎外傷術後2例.臨床錶現為排尿睏難、尿線細.B超檢查提示膀胱殘餘尿及雙腎輸尿管積水,尿動力學檢查提示神經原性膀胱.手術採用跼痳,女性患者在5、6、7點電切膀胱頸至環狀纖維;男性患者在11、1點垂直部分切斷外括約肌.結果 41例均穫隨訪,平均隨訪85(2~252)箇月.手術成功36例(88%),患者排尿通暢,尿流率增加>10 ml/s,腎輸尿管積水減少或消失.無效5例(12%).結論 經尿道電切治療骶神經損傷所緻下尿路排尿功能障礙方法簡便易行、費用低、效果好.
목적 총결경뇨도수술치료신경성배뇨장애적료효급괄응증.방법 신경성배뇨공능장애환자41례.남13례,녀28례.년령12~43세,평균27세.기중저추렬36례、저척막팽출술후2례、저신경류절제술후1례、요추외상술후2례.림상표현위배뇨곤난、뇨선세.B초검사제시방광잔여뇨급쌍신수뇨관적수,뇨동역학검사제시신경원성방광.수술채용국마,녀성환자재5、6、7점전절방광경지배상섬유;남성환자재11、1점수직부분절단외괄약기.결과 41례균획수방,평균수방85(2~252)개월.수술성공36례(88%),환자배뇨통창,뇨류솔증가>10 ml/s,신수뇨관적수감소혹소실.무효5례(12%).결론 경뇨도전절치료저신경손상소치하뇨로배뇨공능장애방법간편역행、비용저、효과호.
Objective To explore the efficacy of transurethral resection of bladder neck(female)and urinary sphincter(male)to treat neurogenic urinary dysfunction. Methods Forty-one patients(28 women and 13 men)with neurogenic urinary dysfunction(dysuria)were retrospectively analyzed.All patients had sacral neurological damage.The mean patient age was 27(12-43)years.All patients had urinary retention and ureter dilation.Twenty-nine patients had renal function damage.Residual urine volume was 151-700 ml(mean 420 m1).MFR was 4-14 ml/s.After local anesthesia,bladder neck(female)was incised at 5,6,7 o'clock to the circle fiber.Urinary sphincter(male) was cut off at 11,1 o'clock and was dilated using sound(F24-F27).The catheterization time was 1-2 weeks. Results All 41 patients were followed up,from 2 months to 252 months,average 85 months.Thirty-six patients(88%)were completely recovered with no residual urine,no dilation of ureter and pelvis,no renal function damage.of these 36 cases,surgery was carried out once for 1 patient,twice for 20 and 3 times for 15.Five patients(12%)were not improved. Conclusion Transurethral resection of bladder neck(female)and urinary sphincter(reale)to treat neurogenic urinary dysfunction could be an effective method.