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中国神经源性膀胱功能低下学龄儿童清洁间歇性自我导尿的尿动力学参数变化及并发症

Urodynamic parameters development and complications of clean intermittent self-catheterization in Chinese schoolchildren with neurogenic underactive bladder.

作者信息

Wang Qing Wei, Song Dong Kui, Zhang Xue Pei, Wu Yu Dong, Zhang Rui Li, Wei Jin Xing, Wen Jian Guo

机构信息

Department of Urology and Urodynamic Center, First Affiliated Hospital of Zhengzhou University, Zhengzhou City, China.

出版信息

Urol Int. 2011;86(4):461-5. doi: 10.1159/000324481. Epub 2011 May 10.

Abstract

OBJECTIVE

To evaluate the urodynamic parameters, development of bladder function and complications of clean intermittent self-catheterization (CIC) in Chinese schoolchildren with neurogenic underactive bladder.

METHODS

Ninety-three children with neurogenic underactive bladder were successfully treated with CIC or combined with oxybutynin for two years follow-up. According to bladder compliance before CIC, they were subdivided into a normal bladder compliance (NBC) group and a low bladder compliance (LBC) group. Urodynamic parameters and complications were recorded.

RESULTS

At follow-up, the incidence of neurogenic detrusor overactivity was found to have significantly decreased in both groups. Moreover, maximum cystometric capacity (CC) and relatively safe CC in the NBC group was significantly higher than those before CIC. However, relatively safe CC was significantly lower than that before CIC, and detrusor leakage point pressure was significantly higher than that before CIC in the LBC group. The incidences of bacteriuria, vesicureteral reflux (VUR), febrile urinary tract infections (UTI) and macroscopic hematuria were, respectively, 62, 13, 25 and 15%, and those of VUR and febrile UTI in the LBC group were significantly higher than those in the NBC group.

CONCLUSION

For these cases, the complications of CIC are rare, and bladder compliance seems to be correlated with the development of bladder function and complications during CIC.

摘要

目的

评估中国神经源性膀胱收缩功能低下学龄儿童清洁间歇性自我导尿(CIC)的尿动力学参数、膀胱功能发育及并发症情况。

方法

93例神经源性膀胱收缩功能低下患儿成功接受CIC或联合奥昔布宁治疗,并进行为期两年的随访。根据CIC前膀胱顺应性,将其分为正常膀胱顺应性(NBC)组和低膀胱顺应性(LBC)组。记录尿动力学参数及并发症情况。

结果

随访时,两组神经源性逼尿肌过度活动发生率均显著降低。此外,NBC组最大膀胱测压容量(CC)及相对安全CC显著高于CIC前。然而,LBC组相对安全CC显著低于CIC前,且逼尿肌漏点压显著高于CIC前。菌尿症、膀胱输尿管反流(VUR)、发热性泌尿系统感染(UTI)及肉眼血尿的发生率分别为62%、13%、25%和15%,LBC组VUR和发热性UTI的发生率显著高于NBC组。

结论

对于这些病例,CIC的并发症少见,膀胱顺应性似乎与CIC期间膀胱功能发育及并发症相关。

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