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小儿神经源性膀胱的药物治疗——膀胱内注射A型肉毒杆菌毒素

Pharmacotherapy in pediatric neurogenic bladder intravesical botulinum toxin type a.

作者信息

Sager Cristian, Burek Carol, Durán Victor, Corbetta Juan Pablo, Weller Santiago, Juan Bortagaray, López Juan Carlos

机构信息

Urology Department, Hospital de Pediatría S.A.M.I.C. "Prof. Dr. Juan P. Garrahan", Combate de los Pozos No. 1881 (CPA: C 1245 AAM), Buenos Aires, Argentina.

出版信息

ISRN Urol. 2012;2012:763159. doi: 10.5402/2012/763159. Epub 2012 Jun 7.

Abstract

When the neurogenic bladder is refractory to anticholinergics, botulinum toxin type A is used as an alternative. The neurotoxin type A reduces bladder pressure and increases its capacity and wall compliance. Additionally, it contributes to improving urinary continence and quality of life. This novel therapy is ambulatory with a low incidence of adverse effects. Due to its transitory effect, it is necessary to repeat the injections in order to sustain its therapeutic effect. In these review article we talk about Mechanism of Action, Indications, effects, administration and presentations of the Botulinum Neurotoxin Type A in pediatric patients. Also, we make references to controversial issues surrounding its use. A bibliographic search was done selecting articles and revisions from Pubmed. The key words used were botulinum toxin A, neurogenic bladder, and children. The search was limited to patients younger than 18 years of age and reports written in English in the past ten years.

摘要

当神经源性膀胱对抗胆碱能药物难治时,A型肉毒杆菌毒素可作为替代药物使用。A型神经毒素可降低膀胱压力,增加膀胱容量和膀胱壁顺应性。此外,它有助于改善尿失禁和生活质量。这种新型疗法无需住院,不良反应发生率低。由于其作用短暂,有必要重复注射以维持其治疗效果。在这篇综述文章中,我们探讨了A型肉毒杆菌神经毒素在儿科患者中的作用机制、适应症、效果、给药方式和剂型。此外,我们还提及了围绕其使用的争议性问题。通过在PubMed上检索文章和综述进行了文献检索。使用的关键词为肉毒杆菌毒素A、神经源性膀胱和儿童。检索仅限于18岁以下的患者以及过去十年用英文撰写的报告。

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本文引用的文献

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The use of botulinum neurotoxin type A (BoNTA) in urology.A型肉毒杆菌神经毒素(BoNTA)在泌尿外科中的应用。
J Neural Transm (Vienna). 2008;115(4):593-605. doi: 10.1007/s00702-007-0862-x. Epub 2008 Mar 6.

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