Träff Helen, Börjesson Anna, Salö Martin
Department of Clinical Sciences, Pediatrics, Lund University, 22185 Lund, Sweden.
Children (Basel). 2021 Mar 10;8(3):209. doi: 10.3390/children8030209.
The primary aim was to describe patient-reported morbidity from neurogenic bladder and bowel dysfunction in a cohort of children with spina bifida. The secondary aim was to describe the overall surgical burden in these children.
Children with meningocele or myelomeningocele, born between 2000-2016, and followed by a tertiary spina bifida center were evaluated in a cross-sectional cohort study using data from charts and a prospective national follow-up program.
In the group of 62 patients, clean intermittent catheterization (CIC) was used by 47 (76%) of the patients, and anticholinergic treatment was used by 36 (58%). More than one third of the patients reported inadequate results with daily urinary leakage. Laxatives and enema were used regularly by 45 (73%) and 39 (63%) patients, respectively. Inadequate results were reported by seven (11%) patients. One or more urogenital or gastrointestinal operations had been performed in 26 (42%) patients, with a total of 109 procedures overall.
Despite substantial bowel and bladder management, a significant portion of children suffered from inadequate results concerning bladder and bowel control. Many surgeries were performed in a defined group of the children. Prospective, long-term studies can evaluate if more aggressive medical and/or surgical management could increase bowel and bladder control.
主要目的是描述脊柱裂患儿队列中患者报告的神经源性膀胱和肠道功能障碍的发病率。次要目的是描述这些儿童的总体手术负担。
在一项横断面队列研究中，对2000年至2016年出生、由三级脊柱裂中心随访的脑脊膜膨出或脊髓脊膜膨出患儿进行评估，使用病历数据和一项全国性前瞻性随访项目的数据。
在62例患者组中，47例（76%）患者使用清洁间歇性导尿（CIC），36例（58%）患者使用抗胆碱能治疗。超过三分之一的患者报告每日漏尿效果不佳。分别有45例（73%）和39例（63%）患者定期使用泻药和灌肠剂。7例（11%）患者报告效果不佳。26例（42%）患者接受了一次或多次泌尿生殖系统或胃肠道手术，总共进行了109次手术。
尽管进行了大量的肠道和膀胱管理，但仍有很大一部分儿童在膀胱和肠道控制方面效果不佳。在特定儿童群体中进行了许多手术。前瞻性长期研究可以评估更积极的药物和/或手术管理是否能增强肠道和膀胱控制。
