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经尿道电刺激疗法对伴有脊柱裂儿童尿动力学模式的影响:10 年经验。

Effects of intravesical electrical stimulation therapy on urodynamic patterns for children with spina bifida: a 10-year experience.

机构信息

Department of Pediatric Urology, Severance Children's Hospital, Yonsei University Health System, Seoul, Republic of Korea.

出版信息

J Pediatr Urol. 2013 Dec;9(6 Pt A):798-803. doi: 10.1016/j.jpurol.2012.10.019. Epub 2012 Nov 21.

Abstract

OBJECTIVE

Intravesical electrical stimulation (IVES) has been performed for various purposes in children with a neurogenic bladder. We evaluated the results of IVES on urodynamic study parameters in children with spina bifida.

METHODS

We retrospectively analyzed the cases of 88 children who received IVES between August 1999 and May 2010 and whose comparative urodynamic data were available before and after treatment. According to the pre-IVES urodynamic study, children were divided into 3 groups: detrusor overactivity, detrusor underactivity and acontractile detrusor. We investigated the changes in detrusor function, bladder capacity and detrusor-sphincter dyssynergia.

RESULTS

In the group showing detrusor overactivity, the bladder had a synergic pattern in 41.7%, and normal detrusor function was observed in 16.7% of them. Bladder capacity increased after IVES therapy, especially in those who started therapy before 18 months of age (p = 0.019). Detrusor-sphincter dyssynergia was resolved in 55.6%. In the acontractile detrusor group, detrusor contraction ability increased in 48%, but bladder capacity did not.

CONCLUSIONS

Appropriate candidates for this treatment need to be carefully selected.

摘要

目的

在儿童神经源性膀胱中,已经进行了各种目的的膀胱内电刺激(IVES)。我们评估了IVES 在脊髓裂儿童尿动力学研究参数上的结果。

方法

我们回顾性分析了 1999 年 8 月至 2010 年 5 月间接受 IVES 治疗且治疗前后有对比性尿动力学数据的 88 例儿童的病例。根据术前尿动力学研究,儿童被分为 3 组:逼尿肌过度活动、逼尿肌活动低下和无收缩性逼尿肌。我们调查了逼尿肌功能、膀胱容量和逼尿肌-括约肌协同失调的变化。

结果

在逼尿肌过度活动组中,41.7%的膀胱呈协同模式,其中 16.7%表现为正常逼尿肌功能。IVES 治疗后膀胱容量增加,尤其是在 18 个月前开始治疗的患者中(p=0.019)。55.6%的患者逼尿肌-括约肌协同失调得到解决。在无收缩性逼尿肌组中,48%的患者逼尿肌收缩能力增加,但膀胱容量没有增加。

结论

需要仔细选择适合这种治疗的患者。

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