中华小儿外科杂志
中華小兒外科雜誌
중화소인외과잡지
CHINESE JOURNAL OF PEDIATRIC SURGERY
2014年
9期
647-651
,共5页
徐智慧%张耀光%张琦%吴慧峰%张大宏%王建业
徐智慧%張耀光%張琦%吳慧峰%張大宏%王建業
서지혜%장요광%장기%오혜봉%장대굉%왕건업
膀胱,神经原性%尿动力学%可植入的神经刺激器
膀胱,神經原性%尿動力學%可植入的神經刺激器
방광,신경원성%뇨동역학%가식입적신경자격기
Bladder,neurogenic%Urodynamics%Implantable neurostimulators
目的 探讨骶神经调节对青少年神经源性膀胱的疗效及安全性.方法 回顾性分析2013年6月至2013年11月收治的2例青少年神经源性膀胱应用骶神经调节技术治疗的临床资料,并结合文献复习讨论.2例患儿均表现为排尿费力,伴尿频及便秘,1例残余尿量120 ml,另1例残余尿量360 ml;尿动力学检查结果为逼尿肌收缩乏力.分别进行骶3神经电极植入体外测试4周,经排尿日记及尿动力学参数评估,均获得明显改善,随后行刺激器永久性植入术.结果 术后患儿排尿费力、尿频及便秘症状明显减轻,2例患儿残余尿量分别降至20 ml和50 ml.排尿日记及尿动力学参数评估(排尿量、最大尿流率、逼尿肌收缩压)较术前好转.分别随访6个月和11个月,疗效稳定,未见不良反应.结论 骶神经调节可以改善青少年神经源性膀胱的排尿及便秘症状,安全性高,但仍需大样本随机对照研究来确定此技术对儿童神经源性膀胱的长期疗效及安全性.
目的 探討骶神經調節對青少年神經源性膀胱的療效及安全性.方法 迴顧性分析2013年6月至2013年11月收治的2例青少年神經源性膀胱應用骶神經調節技術治療的臨床資料,併結閤文獻複習討論.2例患兒均錶現為排尿費力,伴尿頻及便祕,1例殘餘尿量120 ml,另1例殘餘尿量360 ml;尿動力學檢查結果為逼尿肌收縮乏力.分彆進行骶3神經電極植入體外測試4週,經排尿日記及尿動力學參數評估,均穫得明顯改善,隨後行刺激器永久性植入術.結果 術後患兒排尿費力、尿頻及便祕癥狀明顯減輕,2例患兒殘餘尿量分彆降至20 ml和50 ml.排尿日記及尿動力學參數評估(排尿量、最大尿流率、逼尿肌收縮壓)較術前好轉.分彆隨訪6箇月和11箇月,療效穩定,未見不良反應.結論 骶神經調節可以改善青少年神經源性膀胱的排尿及便祕癥狀,安全性高,但仍需大樣本隨機對照研究來確定此技術對兒童神經源性膀胱的長期療效及安全性.
목적 탐토저신경조절대청소년신경원성방광적료효급안전성.방법 회고성분석2013년6월지2013년11월수치적2례청소년신경원성방광응용저신경조절기술치료적림상자료,병결합문헌복습토론.2례환인균표현위배뇨비력,반뇨빈급편비,1례잔여뇨량120 ml,령1례잔여뇨량360 ml;뇨동역학검사결과위핍뇨기수축핍력.분별진행저3신경전겁식입체외측시4주,경배뇨일기급뇨동역학삼수평고,균획득명현개선,수후행자격기영구성식입술.결과 술후환인배뇨비력、뇨빈급편비증상명현감경,2례환인잔여뇨량분별강지20 ml화50 ml.배뇨일기급뇨동역학삼수평고(배뇨량、최대뇨류솔、핍뇨기수축압)교술전호전.분별수방6개월화11개월,료효은정,미견불량반응.결론 저신경조절가이개선청소년신경원성방광적배뇨급편비증상,안전성고,단잉수대양본수궤대조연구래학정차기술대인동신경원성방광적장기료효급안전성.
Objective To evaluate the efficacy and safety of sacral neuromodulation for neurogenic bladder in children.Methods Two children underwent sacral neuromodulation at our hospital from June 2013 to November 2013.Retrospective analyses were conducted for their clinical data and the relevant literatures reviewed.Both had voiding difficulty with frequent urination.The volumes of residual urine were 120 and 360 ml respectively.Urodynamic testing indicated detrusor contraction.After trial stimulation of S3 root,a neuromodulator was implanted into S3 foramen for 4 weeks.Clinical examinations,voiding and bowel diaries and urodynamic and manometric evaluations were performed.Then a permanent stimulator was implanted.Results Voiding difficulty and urinary symptoms were relieved postoperatively.Their volumes of residual urine decreased to 20-50 ml.Voiding diary and urodynamic parameters of urine output,maximum flow rate and detrusor SBP improved versus the preoperative data.During 6 and 11-month follow-ups,efficacy and stability were demonstrate& And no adverse response was found.Conclusions Sacral neuromodulation may improve the voiding symptoms in children with neurogenic bladder.However,large randomized controlled studies are needed to determine its long-term efficacy and safety.
