Yamamoto M, Yasukawa M, Yoshii M, Takahashi S, Natsume O, Momose H, Suemori T, Yamada K, Shiomi T
Department of Urology, Hoshigaoka Koseinenkin Hospital.
Hinyokika Kiyo. 1991 Feb;37(2):117-21.
One hundred and thirteen cases of spina bifida treated with clean intermittent catheterization (CIC) were reviewed. There were 42 males and 71 females, ranging from 4 months to 50 years. The major reasons for CIC from other voiding methods were vesicoureteral reflux (VUR) (48/113) old, and residual urine (36/113). The most common type of neurogenic bladder was hypoactive detrusor-active sphincter, in 56.6% of patients (64/113). The grade of paralytic disability of lower limb (Sharrard's classification) was low (group IV-VI) in 84 patients and high (group I-III) in 29 patients. Hydroureteronephrosis and VUR improved 52.1% (37/71) and 57.1% (36/63), urinary tract infection and urinary incontinence improved 70.9% (39/55) and 81.7% (72/87). Major complications were pyelonephritis (12 cases) and urethral pain (5 cases). We discussed the choice of voiding method in the management of spina bifida.
回顾了113例采用清洁间歇性导尿（CIC）治疗的脊柱裂病例。其中男性42例，女性71例，年龄范围从4个月至50岁。从其他排尿方法改为CIC的主要原因是膀胱输尿管反流（VUR）（48/113）和残余尿（36/113）。最常见的神经源性膀胱类型是逼尿肌活动低下-括约肌活动亢进，占患者的56.6%（64/113）。84例患者下肢瘫痪残疾程度（Sharard分类）较低（IV-VI组），29例患者较高（I-III组）。肾盂积水和VUR改善率分别为52.1%（37/71）和57.1%（36/63），尿路感染和尿失禁改善率分别为70.9%（39/55）和81.7%（72/87）。主要并发症为肾盂肾炎（12例）和尿道疼痛（5例）。我们讨论了脊柱裂治疗中排尿方法的选择。
