Treiber U, Beckert R, Müller M, Thon W F
Urologische Abteilung, Universität Ulm.
Klin Padiatr. 1987 Nov-Dec;199(6):440-4. doi: 10.1055/s-2008-1026835.
In addition to neuropediatrical, neurosurgical and orthopedical care a continuous urological surveillance is indicated in children with myelodysplasia. Urodynamic assessment, voiding cystourethrography, kidney- and residual urine, ultrasound, excretory urography and radioisotope studies at birth and periodically until puberty are performed to evaluate the urinary tract. Early and specific treatment of bladder dysfunction is necessary to prevent urinary infection and preserve renal parenchyma. Urodynamic testing showed evidence of neurogenic bladder dysfunction in 13 of 14 evaluated children (including 8 newborns): detrusor-sphinkter-dyssynergia in 57 percent, detrusor hyperreflexia in 21 percent and detrusor areflexia in 14 percent. 4 of 5 children with detrusor-sphkincter-dyssynergia were treated effectively with anticholinergic agents and clean intermittend catheterization.
除了给予神经儿科、神经外科和骨科护理外，对于患有脊髓发育不良的儿童，还需要进行持续的泌尿外科监测。在出生时以及青春期前定期进行尿动力学评估、排尿性膀胱尿道造影、肾脏和残余尿量检查、超声检查、排泄性尿路造影和放射性同位素检查，以评估尿路情况。早期且针对性地治疗膀胱功能障碍对于预防泌尿系统感染和保护肾实质至关重要。尿动力学测试显示，在14名接受评估的儿童（包括8名新生儿）中，有13名存在神经源性膀胱功能障碍：57%为逼尿肌-括约肌协同失调，21%为逼尿肌反射亢进，14%为逼尿肌无反射。5名患有逼尿肌-括约肌协同失调的儿童中有4名通过抗胆碱能药物和清洁间歇性导尿得到了有效治疗。
