[1]王　苹　谢向辉　张潍平　孙　宁　李明磊　宋宏程　焦丽丽.显性脊柱裂手术前后尿动力学对比分析[J].中国临床神经外科杂志,2019,(08):467-469.[doi:10.13798/j.issn.1009-153X.2019.08.006]
　WANG Ping,XIE Xiang-hui,ZHANG Wei-ping,et al.Changes in urodynamics after repair surgery in children with dominant spina bifida[J].,2019,(08):467-469.[doi:10.13798/j.issn.1009-153X.2019.08.006]
点击复制

显性脊柱裂手术前后尿动力学对比分析()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2019年08期
页码:
467-469
栏目:
论著
出版日期:
2019-08-25

文章信息/Info

Title:
Changes in urodynamics after repair surgery in children with dominant spina bifida
文章编号:
1009-153X（2019）08-0467-03
作者:
王　苹　谢向辉　张潍平　孙　宁　李明磊　宋宏程　焦丽丽
100045 北京，首都医科大学附属北京儿童医院泌尿外科（王　苹、谢向辉、张潍平、孙　宁、李明磊、宋宏程、焦丽丽）
Author(s):
WANG Ping;  XIE Xiang-hui;  ZHANG Wei-ping;  SUN Ning;  LI ming-lei;  SONG Hong-cheng;  JIAO Li-li
Department of Urology, Beijing Children’s Hospital, Capital Medical University, Beijing 100045, China
关键词:
显性脊柱裂; 手术; 尿动力学; 神经源性膀胱; 下尿路功能
Keywords:
Dominant spina bifida;  Urodynamics;  Neurogenic bladder;  Urinary tract function
分类号:
R 744.9; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2019.08.006
文献标志码:
A
摘要:
目的 探讨显性脊柱裂患儿手术前后尿动力学指标及临床表现的变化。方法 回顾性分析手术治疗的26例显性脊柱裂患儿的临床资料，包括12例脂肪瘤型脊髓脊膜膨出、10例脊髓脊膜膨出、4例单纯脊膜膨出。术后随访3~22个月，对比手术前后泌尿系超声、尿动力学检查结果。结果 术前出现下尿路症状8例，未发现肾积水；术后出现下尿路症状9例，新发肾积水2例。术后最大膀胱测定容量较术前明显增加（P<0.05）；而膀胱顺应性、残余尿量、最大膀胱容量时膀胱内压、最大尿流率时逼尿肌压力均无明显变化（P>0.05）。结论 显性脊柱裂术前最常见的尿动力学改变为膀胱排空异常及膀胱顺应性降低；手术前后下尿路功能障碍及短期临床表现改善不明显，需警惕远期并发症。
Abstract:
Objective To analyze the changes in the clinical symptoms and urodynamics after the surgery in the children with dominant spina bifida in order to determine whether there is a correlation between the surgery and change in the lower urinary tract function. Methods The clinical data of 26 children with dominant spina bifida, of whom, 12 suffered from lipomyelomeningocele, 10 from myelomeningocele and 4 from meningocele, were analyzed retrospectively, including the clinical manifestations and outcomes of urodynamic examination before and after the surgery and so on. The repair surgery was performed in all the children in n our department from June, 2016 to December, 2018. Results There were lower urinary tract symptoms in 8 children, but no hydronephrosis was found in all the children before the operation. There were the lowe rurinary tract symptoms in 9 children and there was hydronephrosis in 2 children after the operation. The maximum bladder volume was significantly increased after the operation compared with before the operation (P<0.05). However, there were insignificant differences in the bladder compliance, residual urine volume, and detrusor sphincter dysfunction and detrusor pressure at the maximum urine flow rate between before and after the operation (P>0.05). Conclusions The abnormal bladder emptying and lower bladder compliance are the most common changes in the urinary dynamics before the repair surgery in the children with dominant spina bifida. There was no significant improvement in the lower urinary tract dysfunction and short-term clinical manifestation after the operation compared with before the operation.

参考文献/References:

[1] 中国医师协会神经外科医师分会小儿神经外科专家委员 会. 先天性脊柱裂的常见类型及手术对策专家共识[J]. 中华神经外科杂志，2016，32（4）：331-335. [2] Palmer LS, Richards I, Kaplan WE. Age related bladder capacity and bladder capacity growth in children with myelomeningocele [J]. J Urol, 1997, 158: 1261-1264. [3] Nevéus T, von Gontard A, Hoebeke P, et al. The standardi- zation of terminology of lower urinary tract function in children and adolescents: report from the Standardisation Committee of the International Children’s Continence Society [J]. J Urol, 2006, 176(1): 314-324. [4] Austin PF, Bauer SB, Bower W, et al. The standardization of terminology of lower urinary tract function in children and adolescents: update report from the standardization com- mittee of the International Children’s Continence Society [J]. Neurourol Urodyn, 2016, 35(4): 471-481. [5] Shin M, Besser LM, Siffel C, et al. Prevalence of spina bifida among children and adolescents in 10 regions in the United States[J]. Pediatrics, 2010,126(2): 274-279. [6] Sager C, Burek C, Corbetta JP, et al. Initial urological eva- luation and management of children with neurogenic bladder due to myelomeningocele [J]. J Pediatr Urol, 2017, 13(3): 271. [7] Kumar R, Singhal N, Gupta M, et al. Evaluation of clinico- urodynamic outcome of bladder dysfunction after surgery in children with spinal dysraphism--a prospective study [J]. Acta Neurochir (Wien), 2008, 150(2): 129-137. [8] 刘会范, 文建国, 王庆伟, 等. 囊性脊柱裂修补术前后尿动 力学评估及临床意义[J]. 中华小儿外科杂志, 2003，24 （5）：96-97. [9] Abrahamsson K, Olsson I, Sillén U. Urodynamic findings in children with myelomeningocele after untethering of the spinal cord [J]. J Urol, 2007, 177: 331-334. [10] Kumar R, Singhal N, Gupta M, et al. Evaluation of clinico- urodynamic outcome of bladder dysfunction after surgery in children with spinal dysraphism- a prospective study [J]. Acta Neurochir (Wien), 2008, 150(2): 129-137. [11] Bawa M, Dash V, Kalavant A, et al. Is urodynamic evalua- tion a must in all operated cases of open neural tube defects [J]. J Pediatr Urol, 2017, 13(6): 611-614. [12] St?hrer M, Blok B, Castro-Diaz D, et al. EAU guidelines on neurogenic lower urinary tract dysfunction [J]. Eur Urol, 2009, 56(1): 81-88. [13] de Jong TPVM, Chrzan R, Klijn AJ, et al. Treatment of the neurogenic bladder in spina bifida [J]. Pediatr Nephrol, 2008, 23(6): 889-896. [14] Maison P, Lazarus J. The management of paediatric neuro- genic bladder: an approach in a resource-poor setting [J]. Paediatr Int Child Health, 2017, 37(4): 280-285.

相似文献/References:

[1]王振宇.脊髓髓内肿瘤诊断与治疗中若干问题的讨论[J].中国临床神经外科杂志,2015,(11):641.[doi:10.13798/j.issn.1009-153X.2015.11.001]
[2]黄　斌　李全才　张庭荣　郭运发　吴　昊　罗　坤.内镜 下与显微镜下经蝶手术治疗症状性Rathke囊肿的对比分析[J].中国临床神经外科杂志,2016,(05):264.[doi:10.13798/j.issn.1009-153X.2016.05.003]
　HUANG Bin,LI Quan-cai,ZHANG Ting-rong,et al.Surgery through transsphenoidal approach for symptomatic rathke cleft cysts: endoscopic surgery vs microsurgery[J].,2016,(08):264.[doi:10.13798/j.issn.1009-153X.2016.05.003]
[3]谢宝树　张　林　王　宇　贾　锋　殷玉华.复发性多发胶质母细胞瘤的预后分析[J].中国临床神经外科杂志,2016,(06):333.[doi:10.13798/j.issn.1009-153X.2016.06.005]
　XIE Bao-shu,ZHANG Lin,WANG Yu,et al.Analysis of prognoses in patients with recurrent multiple glioblastomas[J].,2016,(08):333.[doi:10.13798/j.issn.1009-153X.2016.06.005]
[4]陈正和　陈忠平.高级别胶质瘤的治疗现状及思考[J].中国临床神经外科杂志,2016,(06):350.[doi:10.13798/j.issn.1009-153X.2016.06.010]
[5]满明昊　李立宏　杨彦龙　李　敏　郭少春.颅脑损伤术后细胞免疫指标变化及脾多肽对其影响[J].中国临床神经外科杂志,2016,(06):362.[doi:10.13798/j.issn.1009-153X.2016.06.014]
　MAN Ming-hao,LI Li-hong,YANG Yan-yong,et al.Changes in peripheral cells immunity after operation and effect of spleen polypeptide on them in patients with traumatic brain injury[J].,2016,(08):362.[doi:10.13798/j.issn.1009-153X.2016.06.014]
[6]柯燕燕　周春霞　瞿建美　马丽萍.颞叶癫痫丙泊酚Wada试验中护理配合[J].中国临床神经外科杂志,2016,(06):380.[doi:10.13798/j.issn.1009-153X.2016.06.022]
[7]马　磊　张海红　郭　康　孙树凯　张　亮　贾　栋.神经导航辅助下手术治疗侧脑室脑膜瘤1例[J].中国临床神经外科杂志,2016,(04):255.[doi:10.13798/j.issn.1009-153X.2016.04.023]
[8]王亚平　贾晓雄　王　珺　王林林　谭溢涛　马德得　夏鹤春.神经内镜下与显微镜下经鼻蝶入路手术切除垂体腺瘤的疗效对比分析[J].中国临床神经外科杂志,2016,(03):145.[doi:10.13798/j.issn.1009-153X.2016.03.004]
　WANG Ya-ping,JIA Xiao-xiong,WANG-Jun,et al.Resection of pituitary adenomas by endoscopic and microscopic surgery via transnasal transsphenoidal approach: a comparative analysis[J].,2016,(08):145.[doi:10.13798/j.issn.1009-153X.2016.03.004]
[9]惠超杰　李文辉　曹立新　张广华.老年高血压小脑出血的小骨窗手术治疗[J].中国临床神经外科杂志,2016,(02):105.[doi:10.13798/j.issn.1009-153X.2016.02.016]
[10]赵建平　甘文芳　陈小奇　陈娇红　韩　琴　谢永香　张红波　孙彦辉.运动区脑肿瘤术后肢体功能障碍的康复护理[J].中国临床神经外科杂志,2016,(02):118.[doi:10.13798/j.issn.1009-153X.2016.02.023]

备注/Memo

备注/Memo:
基金项目：北京市医院管理局“登峰”人才培养计划（DFL20151102）；北京市医院管理局“扬帆计划”：小儿泌尿外科（ZYLX201709）通讯作者：谢向辉，E-mail：xiexianghui@bch.com.cn（2019-03-25收稿，2019-06-24修回）
更新日期/Last Update: 2019-08-25