CAJ | 학술논문

目的观察超声引导肉毒毒素A(BTX-A)注射尿道外括约肌治疗排尿功能障碍的可行性.方法神经源性膀胱患者22例,按排尿功能障碍分类,逼尿肌尿道括约肌障碍7例(A组),逼尿肌无力10例(B组),尿道括约肌失弛缓5例(C组).3组患者均在超声引导下经会阴穿刺向尿道外括约肌分3个点注射肉毒素(BTX-A) 100 U.3组患者均于治疗4周后进行疗效评定,疗效标准依据患者的主观的排尿感觉和尿流动力学的客观检查结果进行判断.结果治疗后,3组患者中,A组优3例(43％)、良3例(43％)；B组优3例(60％)、良2例(40％)；C组优5例(50％),良3例(30％).治疗后,3组患者的各项尿动力学参数与组内治疗前比较,均有显著改善(P＜0.05),且所有患者未出现明显不良反应.结论超声波定位尿道外括约肌注射BTX-A治疗下尿路功能障碍,是一项简单、可重复应用的治疗方法.
목적 관찰초성인도육독독소A(BTX-A)주사뇨도외괄약기치료배뇨공능장애적가행성.방법 신경원성방광환자22례,안배뇨공능장애분류,핍뇨기뇨도괄약기장애7례(A조),핍뇨기무력10례(B조),뇨도괄약기실이완5례(C조).3조환자균재초성인도하경회음천자향뇨도외괄약기분3개점주사육독소(BTX-A) 100 U.3조환자균우치료4주후진행료효평정,료효표준의거환자적주관적배뇨감각화뇨류동역학적객관검사결과진행판단.결과 치료후,3조환자중,A조우3례(43％)、량3례(43％)；B조우3례(60％)、량2례(40％)；C조우5례(50％),량3례(30％).치료후,3조환자적각항뇨동역학삼수여조내치료전비교,균유현저개선(P＜0.05),차소유환자미출현명현불량반응.결론 초성파정위뇨도외괄약기주사BTX-A치료하뇨로공능장애,시일항간단、가중복응용적치료방법.
Objective To investigate the effectiveness of botulinum toxin A (BTX-A) injection to the external urethral sphincter guided by ultrasound in the treatment of various types of lower urinary tract dysfunction.Methods Twenty-two patients with urinary retention caused by neurological dysfunction (neurogenic bladder) were recruited,of which 18 were men and 4 women.They had various types of lower urinary tract dysfunction including detrusor external sphincter dyssynergia (DESD) in 7,nonrelaxing urethral sphincters in 5,and detrusor underactivity in 10.BTX-A (100 U) was injected into the external urethral sphincter at three different points guided by ultrasound.Clinical effects and urodynamic parameters were compared at baseline and after treatment.Results After treatment the urinary function and urodynamic parameters in each group improved significantly compared with the baseline.Maximum efficacy was observed at the 4th week.In the DESD group,3 patients (43％) had an excellent result and 3 (43％) had significant improvement; in the nonrelaxing sphincter group 3 (60％) had excellent results and 2 (40％) showed significant improvement; in the detrusor underactivity group 5 (50％) had excellent results and 3 (30％) had significant improvement.There were no obvious side effects.Conclusions BTX-A injections guided by ultrasound can accurately locate the external urethral sphincter.It is a simple and repeatable method for the treatment of lower urinary tract dysfunction.