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
652-655
,共4页
胡金华%罗真东%李忠民%刘国昌%张丽瑜%龙旺军%李京军
鬍金華%囉真東%李忠民%劉國昌%張麗瑜%龍旺軍%李京軍
호금화%라진동%리충민%류국창%장려유%룡왕군%리경군
膀胱,神经原性%辣椒辣素%尿动力学
膀胱,神經原性%辣椒辣素%尿動力學
방광,신경원성%랄초랄소%뇨동역학
Bladder,neurogenic%Capsaicin%Urodynamics
目的 探讨清洁间歇导尿(clean intermittent self-catheterization,CIC)联合膀胱灌注辣椒辣素类似物(resiniferatoxin,RTX)治疗儿童神经源性膀胱(neurogenic bladder,NB)并逼尿肌过度活动(detrusoroveractivity,DO)的疗效.方法 将NB并DO患儿38例,按随机数字表法分为CIC联合RTX灌注组(实验组,20例)和CIC联合30％乙醇灌注组(对照组,18例).采用前瞻性双盲平行对照试验,所有患儿在CIC期间每4周行1次灌注治疗,每3个月行尿动力学检查随访,治疗1年后对比两组患儿尿动力学参数异同.结果 治疗后3个月及12个月实验组患儿逼尿肌过度活动的发生率(40.0％和10.0％)明显低于对照组(94.4％和88.9％),差异有统计学意义(P＜0.01).治疗12个月后实验组首次过度活动膀胱容量明显增大[(107.8±46.3)ml vs (68.2±31.5)ml,膀胱安全容量明显增多[(206.8±50.6)ml vs (166.3±54.2)ml],与对照组比较,差异有统计学意义(P＜0.01).但实验组和对照组比较,膀胱顺应性[(20.8±11.5)ml/cmH2O vs (24±15.4) ml/cmH2O],最大尿流率[(9.5±5.1)ml/s vs (8.2±3.2) ml/s]差异均无统计学意义(P＞0.05).结论 CIC联合RTX膀胱灌注能显著控制神经源性膀胱患儿的逼尿肌过度活动,改善神经源性逼尿肌过度活动患儿的生活质量.
目的 探討清潔間歇導尿(clean intermittent self-catheterization,CIC)聯閤膀胱灌註辣椒辣素類似物(resiniferatoxin,RTX)治療兒童神經源性膀胱(neurogenic bladder,NB)併逼尿肌過度活動(detrusoroveractivity,DO)的療效.方法 將NB併DO患兒38例,按隨機數字錶法分為CIC聯閤RTX灌註組(實驗組,20例)和CIC聯閤30％乙醇灌註組(對照組,18例).採用前瞻性雙盲平行對照試驗,所有患兒在CIC期間每4週行1次灌註治療,每3箇月行尿動力學檢查隨訪,治療1年後對比兩組患兒尿動力學參數異同.結果 治療後3箇月及12箇月實驗組患兒逼尿肌過度活動的髮生率(40.0％和10.0％)明顯低于對照組(94.4％和88.9％),差異有統計學意義(P＜0.01).治療12箇月後實驗組首次過度活動膀胱容量明顯增大[(107.8±46.3)ml vs (68.2±31.5)ml,膀胱安全容量明顯增多[(206.8±50.6)ml vs (166.3±54.2)ml],與對照組比較,差異有統計學意義(P＜0.01).但實驗組和對照組比較,膀胱順應性[(20.8±11.5)ml/cmH2O vs (24±15.4) ml/cmH2O],最大尿流率[(9.5±5.1)ml/s vs (8.2±3.2) ml/s]差異均無統計學意義(P＞0.05).結論 CIC聯閤RTX膀胱灌註能顯著控製神經源性膀胱患兒的逼尿肌過度活動,改善神經源性逼尿肌過度活動患兒的生活質量.
목적 탐토청길간헐도뇨(clean intermittent self-catheterization,CIC)연합방광관주랄초랄소유사물(resiniferatoxin,RTX)치료인동신경원성방광(neurogenic bladder,NB)병핍뇨기과도활동(detrusoroveractivity,DO)적료효.방법 장NB병DO환인38례,안수궤수자표법분위CIC연합RTX관주조(실험조,20례)화CIC연합30％을순관주조(대조조,18례).채용전첨성쌍맹평행대조시험,소유환인재CIC기간매4주행1차관주치료,매3개월행뇨동역학검사수방,치료1년후대비량조환인뇨동역학삼수이동.결과 치료후3개월급12개월실험조환인핍뇨기과도활동적발생솔(40.0％화10.0％)명현저우대조조(94.4％화88.9％),차이유통계학의의(P＜0.01).치료12개월후실험조수차과도활동방광용량명현증대[(107.8±46.3)ml vs (68.2±31.5)ml,방광안전용량명현증다[(206.8±50.6)ml vs (166.3±54.2)ml],여대조조비교,차이유통계학의의(P＜0.01).단실험조화대조조비교,방광순응성[(20.8±11.5)ml/cmH2O vs (24±15.4) ml/cmH2O],최대뇨류솔[(9.5±5.1)ml/s vs (8.2±3.2) ml/s]차이균무통계학의의(P＞0.05).결론 CIC연합RTX방광관주능현저공제신경원성방광환인적핍뇨기과도활동,개선신경원성핍뇨기과도활동환인적생활질량.
Objective To explore the effects of clean intermittent catheterization (CIC) coupled with resiniferatoxin (RTX) intravesical instillations in children with neurogenic detrusor overactivity (DO).Methods A total of 38 patients with neurogenic detrusor overactivity were enrolled and randomly divided into experimental (n =20) and control (n =18) groups.The experimental group underwent CIC and 4 weekly intravesical instillations of 10 nmol/L resiniferatoxin while the control group CIC and 4 weekly intravesical instillations of 30％ ethanol.The urodynamic parameters were assessed after 1 year follow-up.Results The resiniferatoxin treatment group had a significantly lower percent of DO compared to the control group (3 months:40％ vs 94.4％; 12 months:10％ vs 88.9％,P＜0.01).Bladder capacity for the first DO [(107.8 ± 46.3)vs (68.2 ± 31.5)ml] and safety bladder capacity (SBC) [(206.8 ± 50.6) vs (166.3 ± 54.2) ml] significantly increased 12 months after treatment in the resiniferatoxin group than in the control group while the bladder compliance (BC)[(20.8 ± 11.5)vs (24 ± 15.4)ml/cmH2O]-and maximum flow rate (MFR) [(9.5 ± 5.1)ml/s vs (8.2 ± 3.2)ml/s] had no statistical significance between two groups (P＞0.05).Conclusions Intermittent catheterization plus resiniferatoxin intravesical instillations can reduce DO in children with neurogenic bladder.
