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[树脂毒素治疗神经源性膀胱的临床研究]

[Clinical study of resiniferatoxin on neurogenic bladder].

作者信息

Liu Tie-jun, Zhao Meng-jie, Sha Ke-fu, Gao Ju-zhong

机构信息

Department of Neurourology, Beijing Xishan Hospital, Beijing Rehabilitation Center, Beijing 100144, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2010 Jul 13;90(26):1827-9.

Abstract

OBJECTIVE

To understand the effect of resiniferatoxin on neurogenic bladder by intravesical filling.

METHODS

Twenty-four male spinal cord injury patients with an obviously low cystometric capacity, 2 incomplete cervical cord injury, 5 complete thoracic cord injury, 4 incomplete thoracic cord injury, 5 incomplete lumbar cord injury and 8 complete lumbar cord injury were examined. The age range was 24 - 58 years old and the course of disease 1 - 6 years. There were 0.0063 mg/4 ml RTX in each bottle, it was dissolved in 50 ml physiologic saline and was infused into bladder slowly, kept 30 min, then was discharged by intermittent catheterization (IC). During the process, the patients were requested to fill a micturition chart and conduct urodynamic examination before and after the infusion. We regulated that it was utility when the amount of increased maximal cystometric capacity (MCC) exceeded or was 100 ml, otherwise it was invalid.

RESULTS

The urodynamic examination before intravesical filling and 1 week after intravesical filling showed that the average MCC were (210 ± 23) ml and (360 ± 30) ml respectively, the average bladder compliance were (17 ± 3) ml/cm H2O and (24 ± 5) ml/cm H2O, there were statistic difference between them (both P < 0.01). The overall effective rate was 62.5%. It lasted 1 - 4 months.

CONCLUSION

Resiniferatoxin is effective to increase the cystometric capacity and booster the bladder compliance.

摘要

目的

通过膀胱灌注了解树脂毒素对神经源性膀胱的影响。

方法

对24例男性脊髓损伤患者进行检查,其中2例为不完全性颈髓损伤,5例为完全性胸髓损伤,4例为不完全性胸髓损伤,5例为不完全性腰髓损伤,8例为完全性腰髓损伤。年龄范围为24 - 58岁,病程1 - 6年。每瓶含0.0063 mg/4 ml RTX,将其溶解于50 ml生理盐水中,缓慢注入膀胱,保留30分钟,然后通过间歇性导尿(IC)排出。在此过程中,要求患者填写排尿图表,并在灌注前后进行尿动力学检查。我们规定,最大膀胱测压容量(MCC)增加量超过或等于100 ml为有效,否则为无效。

结果

膀胱灌注前及灌注后1周的尿动力学检查显示,平均MCC分别为(210±23)ml和(360±30)ml,平均膀胱顺应性分别为(17±3)ml/cm H2O和(24±5)ml/cm H2O,两者之间存在统计学差异(均P < 0.01)。总有效率为62.5%。疗效持续1 - 4个月。

结论

树脂毒素可有效增加膀胱测压容量并提高膀胱顺应性。

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