中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2010年
26期
1827-1829
,共3页
刘铁军%赵盟杰%沙可夫%高居忠
劉鐵軍%趙盟傑%沙可伕%高居忠
류철군%조맹걸%사가부%고거충
膀胱,神经原性%尿动力学%辣椒属%最大膀胱容量%膀胱顺应性
膀胱,神經原性%尿動力學%辣椒屬%最大膀胱容量%膀胱順應性
방광,신경원성%뇨동역학%랄초속%최대방광용량%방광순응성
Bladder,neurogenic%Urodynamics%Capsicum%Maximal cystometric capacity%Bladder compliance
目的 探讨辣椒辣素类似物(RTX)对神经原性膀胱的影响.方法 选择最大膀胱容量<250 ml的脊髓损伤患者24例,患者均为男性,均存在膀胱尿道功能障碍,不能自主排尿,行间歇导尿4～6次/d.依据损伤的部位和程度分类,包括颈髓不全损伤2例,胸髓完全损伤5例,胸髓不完全损伤4例,腰髓完全损伤8例,腰髓不完全损伤5例;年龄24～58岁;病程1-6年,平均2.3年.RTX每支含量0.0063 mg/4 ml,溶于50 ml生理盐水中,缓慢注入排空膀胱内,保留30 min,然后予以间歇导尿排空膀胱.记录接受RTX膀胱内灌注前后最大膀胱容量和膀胱顺应性的变化.以灌注后最大膀胱容量增加≥100 ml为有效,否则为无效.结果 灌药前及灌药1周后尿动力学检测提示最大膀胱容量分别为(210±23)ml和(360士30)ml;膀胱顺应性分别为(17±3)ml/cm H2O和(24 ±5)ml/cm H2O(1 cm H2O=0.098 kPa),灌药前后两指标差异均有统计学意义(均P<0.01).共15例有效,9例无效,总有效率62.5%,有效期持续1-4个月不等.结论 RTX膀胱内灌注对于神经原性膀胱具有一定的扩大膀胱容量,增加膀胱顺应性,减少漏尿的作用.
目的 探討辣椒辣素類似物(RTX)對神經原性膀胱的影響.方法 選擇最大膀胱容量<250 ml的脊髓損傷患者24例,患者均為男性,均存在膀胱尿道功能障礙,不能自主排尿,行間歇導尿4～6次/d.依據損傷的部位和程度分類,包括頸髓不全損傷2例,胸髓完全損傷5例,胸髓不完全損傷4例,腰髓完全損傷8例,腰髓不完全損傷5例;年齡24～58歲;病程1-6年,平均2.3年.RTX每支含量0.0063 mg/4 ml,溶于50 ml生理鹽水中,緩慢註入排空膀胱內,保留30 min,然後予以間歇導尿排空膀胱.記錄接受RTX膀胱內灌註前後最大膀胱容量和膀胱順應性的變化.以灌註後最大膀胱容量增加≥100 ml為有效,否則為無效.結果 灌藥前及灌藥1週後尿動力學檢測提示最大膀胱容量分彆為(210±23)ml和(360士30)ml;膀胱順應性分彆為(17±3)ml/cm H2O和(24 ±5)ml/cm H2O(1 cm H2O=0.098 kPa),灌藥前後兩指標差異均有統計學意義(均P<0.01).共15例有效,9例無效,總有效率62.5%,有效期持續1-4箇月不等.結論 RTX膀胱內灌註對于神經原性膀胱具有一定的擴大膀胱容量,增加膀胱順應性,減少漏尿的作用.
목적 탐토랄초랄소유사물(RTX)대신경원성방광적영향.방법 선택최대방광용량<250 ml적척수손상환자24례,환자균위남성,균존재방광뇨도공능장애,불능자주배뇨,행간헐도뇨4～6차/d.의거손상적부위화정도분류,포괄경수불전손상2례,흉수완전손상5례,흉수불완전손상4례,요수완전손상8례,요수불완전손상5례;년령24～58세;병정1-6년,평균2.3년.RTX매지함량0.0063 mg/4 ml,용우50 ml생리염수중,완만주입배공방광내,보류30 min,연후여이간헐도뇨배공방광.기록접수RTX방광내관주전후최대방광용량화방광순응성적변화.이관주후최대방광용량증가≥100 ml위유효,부칙위무효.결과 관약전급관약1주후뇨동역학검측제시최대방광용량분별위(210±23)ml화(360사30)ml;방광순응성분별위(17±3)ml/cm H2O화(24 ±5)ml/cm H2O(1 cm H2O=0.098 kPa),관약전후량지표차이균유통계학의의(균P<0.01).공15례유효,9례무효,총유효솔62.5%,유효기지속1-4개월불등.결론 RTX방광내관주대우신경원성방광구유일정적확대방광용량,증가방광순응성,감소루뇨적작용.
Objective To understand the effect of resiniferatoxin on neurogenic bladder by intravesical filling. Methods Twenty-four male spinal cord injury patients with an obviously low cystometric capacity, 2 incomplete cervical cord injury, 5 complete thoracic cord injury, 4 incomplete thoracic cord injury, 5 incomplete lumbar cord injury and 8 complete lumbar cord injury were examined. The age range was 24-58 years old and the course of disease 1-6 years. There were 0. 0063 mg/4 ml RTX in each bottle.it was dissolved in 50 ml physiologic saline and was infused into bladder slowly, keeped 30 min, then was discharged by intermittent catheterization (IC). During the process, the patients were requested to fill a micturition chart and conduct urodynamic examination before and after the infusion. We regulated that it was utility when the amount of increased maximal cystometric capacity(MCC) exceeded or was 100 ml, otherwise it was invalid. Results The urodynamic examination before intravesical filling and 1 week after intravesical filling showed that the average MCC were (210 ±23) ml and (360 ±30) ml respectively, the average bladder compliance were (17 ±3) ml/cm H2O and (24 ±5) ml/cm H2O, there were statistic difference between them(both P < 0. 01 ). The overall effective rate was 62. 5% . It lasted 1-4 months. Conclusion Resiniferatoxin is effective to increase the cystometric capacity and booster the bladder compliance.
