Department of Neurosurgery, Shanghai Children's Hospital, Shanghai Jiao Tong University, 355 Luding Road, Shanghai, 200062, China.
Department of Urology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, 200062, China.
Sci Rep. 2022 Apr 28;12(1):6962. doi: 10.1038/s41598-022-11057-3.
To investigate the urodynamic study (UDS) result in pediatric patients suffering from spastic cerebral palsy (CP). Medical records of patients diagnosed CP having pre-operative UDS results underwent selective dorsal rhizotomy (SDR) from Jan. 2020 to May. 2021 were retrospectively reviewed. Fifty-seven cases diagnosed spastic CP were included in the study (mean age, 6.73 ± 2.84 years), among which, 46 were ambulatory and 11 non-ambulatory. Average gross motor function measure-66 (GMFM-66) score was 62.16 ± 11.39. Reduced bladder capacity was seen in 49.12% of these cases and cases with lower GMFM-66 score possessed a higher incidence rate of having low bladder capacity (p < 0.01). Detrusor overactivity (DO) was shown in 33.33% of the patients. Cases with younger age presented a higher prevalence of DO (p < 0.05). Meanwhile, more non-ambulant patients suffered from DO (p < 0.05). Increased post-voiding residual (PVR) was seen in 21.05% of the cases. Those with higher average threshold in sphincter-associated input spinal nerve roots (rootlets) witnessed a higher rate of having abnormal PVR (p < 0.05). Abnormal UDS results were prevalent in pediatric patients suffering from CP. Motor function, age and threshold of their sphincter-associated spinal nerve roots laid corresponding effect on the abnormal UDS results.
探讨痉挛型脑瘫(CP)患儿的尿动力学研究(UDS)结果。回顾性分析 2020 年 1 月至 2021 年 5 月期间术前 UDS 结果行选择性脊神经后根切断术(SDR)的 CP 患儿的病历。本研究纳入 57 例痉挛型 CP 患儿(平均年龄 6.73±2.84 岁),其中 46 例为步行患儿,11 例为非步行患儿。平均粗大运动功能测量-66(GMFM-66)评分为 62.16±11.39。49.12%的患儿膀胱容量减少,GMFM-66 评分较低的患儿膀胱容量较低的发生率较高(p<0.01)。33.33%的患儿存在逼尿肌过度活动(DO)。年龄较小的患儿 DO 发生率较高(p<0.05)。同时,更多的非步行患儿患有 DO(p<0.05)。21.05%的患儿存在排尿后残余量(PVR)增加。肛门括约肌相关传入脊神经根(根)平均阈值较高的患儿,其异常 PVR 发生率较高(p<0.05)。患有 CP 的儿科患者中,异常 UDS 结果较为常见。运动功能、年龄和其肛门括约肌相关脊神经根的阈值对异常 UDS 结果有相应的影响。