膀胱小梁化和神经性膀胱与脊髓损伤的关联。
Association of bladder trabeculation and neurogenic bladder with spinal cord injury.
机构信息
Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School, Jeonju, Republic of Korea.
Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea.
出版信息
J Int Med Res. 2022 Jun;50(6):3000605221104768. doi: 10.1177/03000605221104768.
OBJECTIVE
To compare clinical findings and urodynamic parameters according to trabeculation grade and analyze their correlations with trabeculation severity in neurogenic bladder caused by suprasacral spinal cord injury (SCI).
METHODS
A retrospective chart review was performed of neurogenic bladder caused by SCI. Bladder trabeculation grade was compared with SCI-related clinical parameters and bladder-related urodynamic parameters.
RESULTS
In SCI patients, factors such as disease duration, bladder capacity, detrusor pressure, peak detrusor pressure values, and compliance were significantly different between different grades of bladder trabeculation, while neurological level of injury, completeness, and detrusor sphincter dyssynergia had no clear relationship with bladder trabeculation grade. In the correlation analysis, vesicoureteral reflux was moderately correlated with trabeculation grade (correlation coefficient 0.433), while the correlation coefficients of disease duration, involuntary detrusor contraction, and bladder filling volume were between 0.3 and 0.4.
CONCLUSION
Bladder trabeculation with suprasacral-type neurogenic bladder was graded. Although disease duration was positively correlated with bladder trabeculation grade, differences in the neurological level of injury or American Spinal Injury Association Impairment Scale score were not observed. Bladder volume, peak detrusor pressure, compliance, reflex volume, and vesicoureteral reflux also showed significant differences according to trabeculation grade. Vesicoureteral reflux was moderately correlated with trabeculation grade.
目的
比较不同逼尿肌小梁化分级的临床和尿动力学参数，并分析其与上运动神经元损伤所致神经源性膀胱逼尿肌小梁化严重程度的相关性。
方法
对由脊髓损伤导致的神经源性膀胱进行回顾性病历分析。比较膀胱逼尿肌小梁化分级与与脊髓损伤相关的临床参数和与膀胱相关的尿动力学参数。
结果
在脊髓损伤患者中，不同膀胱逼尿肌小梁化分级之间的疾病持续时间、膀胱容量、逼尿肌压力、逼尿肌峰值压力值和顺应性等因素存在显著差异，而损伤的神经水平、完整性和逼尿肌括约肌协同失调与膀胱逼尿肌小梁化分级无明显关系。在相关性分析中，输尿管反流与逼尿肌小梁化分级中度相关（相关系数 0.433），而疾病持续时间、不自主逼尿肌收缩和膀胱充盈量的相关系数在 0.3 到 0.4 之间。
结论
对上运动神经元损伤所致神经源性膀胱进行了膀胱逼尿肌小梁化分级。尽管疾病持续时间与膀胱逼尿肌小梁化分级呈正相关，但损伤的神经水平或美国脊髓损伤协会损伤量表评分无差异。膀胱容量、逼尿肌峰值压力、顺应性、反射容量和输尿管反流也根据逼尿肌小梁化分级显示出显著差异。输尿管反流与逼尿肌小梁化分级中度相关。
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