临床小儿外科杂志Issue(3)：183-185,197,4.DOI:10.3969/j.issn.1671-6353.2015.03.006
神经性膀胱的评价和治疗
The evaluation and treatment of neurogenic bladder
孙小兵 1罗添华 1吕丽丽 1王润香 1安果仙1
作者信息
- 1. 山 西省 儿童医院 外科 山西省 太原 市，030013
- 折叠
摘要
Abstract
Objetive To evaluate the treatment and results of different children with neurogenic blad-der.Methods 15 children with neurogenic bladder were treated between 4,2013 to 1,2014.There were 7 boys and 8 girls who were from 1 year old to 13 years old.All of them were received operation because of my-elomeningocele ever before.Urodynamic,ultrasonography and voiding cystourethrography (VCUG)were fin-ished.Detrusor pressure increased in 8 children.Bladder volume decreased in 12 children.Detrusor overactiv-ity developed in 7 children.Ultrasonography and VCUG indicated hydronephrosis and enlarged ureters in 8 children.7 children developed vesicoureteral reflux.5 children received operations,including enterocystoplasty and ureter reimplantation (Cohen technique)1 patient,enterocystoplasty in 1 patient,reimplantation (Cohen technique)in 1 patient,bladder autoaugmentation and ureter reimplantation (Lich Gregior technique)in 2 pa-tients.10 patients were performed clean intermittent catheterization (CIC),and solifenacin was used in 4 pa-tients.Results Bladder volume increased,detrusor pressure decreased and vesicoureteral reflux disappeared in 2 patients who were performed enterocystoplasty.Bladder volume increased and detrusor pressure decreased a little in 2 patients who were performed bladder autoaugmentation and ureter reimplantation,but vesicoureteral reflux did not disappear.Vesicoureteral reflux disappeared in 1 patient who was performed ureter transplanta-tion.For 6 patients whose bladder volume was larger than two third of expected bladder volume and low detru-sor pressure,urinary incontinence disappeared in 2 patients,ameliorated in 2 patients,had no change in 2 pa-tients after CIC was performed.For 4 patients whose bladder volume was smaller than one second of expected bladder volume and high detrusor pressure,urinary incontinence had no change after CIC was performed.De-trusor overactivity ameliorated in 4 patients who used solifenacin. Conclusions Urodynamic,ultrasonography and VCUG are very important methods to evaluate neurogenic bladder.Different patients should be used differ-ent methods according to the clinical evaluation.关键词
膀胱/畸形/椎管闭合不全/评价研究/治疗Key words
Urinary Bladder/AB/Spinal Dysraphism/Evaluation Studies/Therapy引用本文复制引用
孙小兵,罗添华,吕丽丽,王润香,安果仙..神经性膀胱的评价和治疗[J].临床小儿外科杂志,2015,(3):183-185,197,4.
