Spindel M R, Bauer S B, Dyro F M, Krarup C, Khoshbin S, Winston K R, Lebowitz R L, Colodny A H, Retik A B
JAMA. 1987 Sep 25;258(12):1630-3.
Seventy-nine newborns with myelodysplasia were followed up for 1 1/2 to six years with serial roentgenographic, neurologic, and urodynamic evaluations. Twenty-nine infants (37%) demonstrated changes in external urethral sphincter innervation during the first three years of life. Of the group who changed, 896% (25/29 infants) did so in the first year, 10% (3/29 infants) in the second year, and 4% (1/29 infants) in the third. The risk factor for change was 32%, 6%, and 2%, respectively, during each of these three years. Fifteen infants (19% of the total) experienced neurourologic deterioration while 14 infants (18%) improved. Seven newborns underwent a second neurosurgical procedure resulting in improvement in four, stabilization in two, and further deterioration in one. These findings underline the importance of early and continued neurologic and urologic surveillance in children with myelodysplasia because it is a dynamic disease process.
对79例患有脊髓发育异常的新生儿进行了1.5至6年的随访，期间进行了系列X线、神经学和尿动力学评估。29例婴儿（37%）在生命的头三年中出现了尿道外括约肌神经支配的变化。在出现变化的这组婴儿中，89.6%（25/29例婴儿）在第一年出现变化，10%（3/29例婴儿）在第二年出现变化，4%（1/29例婴儿）在第三年出现变化。在这三年中的每一年，出现变化的风险因素分别为32%、6%和2%。15例婴儿（占总数的19%）出现了神经泌尿系统恶化，而14例婴儿（18%）有所改善。7例新生儿接受了第二次神经外科手术，其中4例病情改善，2例病情稳定，1例病情进一步恶化。这些发现强调了对脊髓发育异常儿童进行早期和持续神经学及泌尿系统监测的重要性，因为这是一个动态的疾病过程。
