CAJ | 학술논문

目的：研究钬激光外括约肌切开术在神经源性膀胱男性患者中的治疗效果及长期随访。方法对20例接受钬激光外括约肌切开术的神经源性膀胱男性患者进行回顾性分析。其中颈髓损伤7例，胸髓损伤6例，圆锥马尾神经损伤3例；脊膜膨出1例，骶裂1例，室管膜瘤术后1例，脊髓炎后遗症1例。年龄20~64岁，平均45.1岁。随访时间3~95个月，平均43.6个月。结果20例患者术后在症状学、实验室检查、影像学和尿动力学指标等方面均获得明显改善。随访过程中3例患者再次行钬激光外括约肌切断。17例患者长期随访效果稳定。结论钬激光外括约肌切开术具有出血少、安全、疗效确切的优点，长期随访效果相对稳定。对于不能实行或不愿实行间歇导尿的男性神经源性膀胱患者，尤其是伴有自主神经过反射、逼尿肌外括约肌协同失调的患者可作为一种有效的治疗方法。
목적：연구화격광외괄약기절개술재신경원성방광남성환자중적치료효과급장기수방。방법대20례접수화격광외괄약기절개술적신경원성방광남성환자진행회고성분석。기중경수손상7례，흉수손상6례，원추마미신경손상3례；척막팽출1례，저렬1례，실관막류술후1례，척수염후유증1례。년령20~64세，평균45.1세。수방시간3~95개월，평균43.6개월。결과20례환자술후재증상학、실험실검사、영상학화뇨동역학지표등방면균획득명현개선。수방과정중3례환자재차행화격광외괄약기절단。17례환자장기수방효과은정。결론화격광외괄약기절개술구유출혈소、안전、료효학절적우점，장기수방효과상대은정。대우불능실행혹불원실행간헐도뇨적남성신경원성방광환자，우기시반유자주신경과반사、핍뇨기외괄약기협동실조적환자가작위일충유효적치료방법。
Objective To explore the technique, efficacy and complications of transurethral sphincterotomy with Holmium laser for the treatment of male patients with neurogenic bladder and examine its long-term outcome. Methods 20 male cases who received transurethral sphincterotomy with Holmium laser were included in this retrospective analysis, in which 7 cases injuried at cervical spinal cord, 6 at thorac-ic spinal cord, 3 at cauda equine;1 was spinal meningocele, 1 was sacral crack, 1 was ependymoma, and 1 was myelitis sequel. The age was 20~64 years, averaged 45.1 years. They were followed up for 3~95 months (averaged 43.6 months) since the last sphincterotomy. Results The 20 patients significantly improved in symptoms, laboratory examination, imaging demonstration and urodynamic index after the opera-tion. There were 3 patients who required repeated laser surgery during the follow-up. 17 patients were stable. Conclusion Transurethral sphincterotomy with Holmium laser is effective on neurogenic bladder with less bleeding for the appropriately selected patients.