CAJ | 학술논문

目的：以脊髓脊膜膨出的婴儿为研究对象，进行术前尿动力学检查，评估其膀胱功能。方法2010年2月至2014年3月，本院收治脊髓脊膜膨出患儿25例，年龄45d至1个月，平均4个月，术前应用加拿大莱博瑞（Laborie）尿动力检查系统，慢速灌注充盈膀胱进行膀胱测压。结果术前尿动力检查结果：尿动力表现完全正常13例（52％）；膀胱活动活跃6例（24％）；间断排尿4例（16％）；逼尿肌不稳定2例，其中1例膀胱顺应性3 mL/cmH2 O。所有患儿膀胱容量正常，（48．3±19.8）mL。残余尿均未见明显增加，平均（3．2±4．5）mL。因膀胱活动活跃、间断排尿多见于正常婴儿，本组23例被认为尿动力结果正常，占92％。所有患儿均经手术确定脊髓脊膜膨出及脊髓栓系诊断，其中脂肪脊髓脊膜膨出15例（占60％）。结论尿动力学检查提示术前脊髓脊膜膨出的婴儿，其膀胱功能多为正常，其神经源性膀胱的损害在1岁以内多未表现出来。
목적：이척수척막팽출적영인위연구대상，진행술전뇨동역학검사，평고기방광공능。방법2010년2월지2014년3월，본원수치척수척막팽출환인25례，년령45d지1개월，평균4개월，술전응용가나대래박서（Laborie）뇨동력검사계통，만속관주충영방광진행방광측압。결과술전뇨동력검사결과：뇨동력표현완전정상13례（52％）；방광활동활약6례（24％）；간단배뇨4례（16％）；핍뇨기불은정2례，기중1례방광순응성3 mL/cmH2 O。소유환인방광용량정상，（48．3±19.8）mL。잔여뇨균미견명현증가，평균（3．2±4．5）mL。인방광활동활약、간단배뇨다견우정상영인，본조23례피인위뇨동력결과정상，점92％。소유환인균경수술학정척수척막팽출급척수전계진단，기중지방척수척막팽출15례（점60％）。결론뇨동역학검사제시술전척수척막팽출적영인，기방광공능다위정상，기신경원성방광적손해재1세이내다미표현출래。
Objetive To evaluate the myelomeningocele infants ’ bladder functions with urodynamic study before operation. Methods From February 201 0 to April 201 4,a total of 25 infants with myelomeningo-cele were included in this study with age from 2 months to 1 1 months old and a mean 4.0 months.Slow-fill cys-tometry examination was performed with Laborie urodynamic system before surgery. Results Urodynamic of 1 3 patients (52%)were completely normal.Hyperactivity of detrusor was found in 6 patients (24%).Interrupt-ed voiding was found in 4 cases (1 6%).2 patients have instable detrusor,among them 1 patient’s bladder compliance is 3 ml/cmH2 O.No obvious increase of residual urine was found in all cases and the mean is 3.2 ±4.5 ml.Because hyperactivity and interrupted voiding are thought to be normal in infants,23 patients (92%)are considered with normal urodynamic results.The diagnosis of myelomeningocele and tethered cord syndrome was confirmed after surgery.Among them,1 5 cases (60%)were diangnosed as lipomyelomeningo-cele post-operation. Conclusion Infants with myelomeningocele have normal bladder function in their first year pre-operation.