Agarwal S K, Bagli D J
Department of Surgery, Hospital for Sick Children, University of Toronto, Canada.
Indian J Pediatr. 1997 May-Jun;64(3):313-26. doi: 10.1007/BF02845201.
Management of neurogenic bladder in children is challenging for the practising clinician. This involves consideration of multiple and diverse factors which must be balanced in an ever changing environment. Also the dynamics of a child's growth must always be considered because it contributes to the ongoing instability of the neurologic lesion. Prevention and proactive approaches have become the mainstay of the therapy. It is not appropriate to wait for problems to occur before treating these children, because changes that take place may not be reversible, even if they are detected early. The clinician should be aware of the various clinical presentations of neurogenic bladder dysfunction in children and familiarize themselves with the modes of treatment available. Long term follow-up is mandatory. Finally, the value of streamlining these children into society at an early age must always be considered.
对于执业临床医生而言,儿童神经源性膀胱的管理颇具挑战性。这涉及到诸多不同因素的考量,而这些因素必须在不断变化的环境中取得平衡。此外,儿童生长发育的动态变化也始终需要加以考虑,因为这会导致神经病变持续不稳定。预防和积极主动的方法已成为治疗的主要手段。在治疗这些儿童时,等待问题出现后再进行处理是不合适的,因为即便早期发现,所发生的变化可能也无法逆转。临床医生应了解儿童神经源性膀胱功能障碍的各种临床表现,并熟悉现有的治疗方式。长期随访是必不可少的。最后,始终必须考虑尽早让这些儿童融入社会的价值。