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[脊髓损伤患者的泌尿系统功能障碍]

[Urinary tract dysfunction in spinal cord injury patients].

作者信息

Moslavac Sasa, Dzidić Ivan, Moslavac Aleksandra, Vlahek Pavao, Filipan Zoran

出版信息

Lijec Vjesn. 2014 May-Jun;136(5-6):147-52.

Abstract

Spinal cord injury (SCI) results with paralysis but also with micturition dysfunction; therefore rehabilitation management and long-term follow-up include lower urinary tract care in order to prevent upper urinary tract pathology and complications. That comprises timely and standardized neurological and urological diagnostics and eliminatory techniques with intermittent catheterisation in majority of patients. Urological diagnostics include blood and urine tests, urine culture, ultrasound and X-ray of urinary tract, and cystometry to assess dynamic properties of neurogenic bladder. It has been proven that incomplete SCI patients have neurogenic bladder with similar findings as patients with complete injuries, i.e. cystometric capacities are reduced while intravesical pressures are increased, which endanger upper urinary tract. Furthermore, it has been shown that there is no difference of these findings between particular levels of injury: cervical, thoracic, thoracic-lumbar and lumbar, so these risks are similar in every group. Conclusively, it is necessary to conduct urinary tract diagnostics in SCI patients for sake of the quality and quantity of patients' lives.

摘要

脊髓损伤(SCI)会导致瘫痪,同时也会引起排尿功能障碍;因此,康复管理和长期随访包括下尿路护理,以预防上尿路病变和并发症。这包括对大多数患者进行及时、标准化的神经学和泌尿学诊断以及采用间歇性导尿的排尿技术。泌尿学诊断包括血液和尿液检查、尿培养、尿路超声和X线检查,以及膀胱测压以评估神经源性膀胱的动态特性。已经证实,不完全性脊髓损伤患者的神经源性膀胱与完全性损伤患者有相似的表现,即膀胱容量减少而膀胱内压升高,这对上尿路构成威胁。此外,研究表明,在损伤的特定水平(颈椎、胸椎、胸腰段和腰椎)之间,这些表现没有差异,因此每组患者面临的这些风险相似。总之,为了提高脊髓损伤患者的生活质量和数量,对其进行尿路诊断是必要的。

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