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[脊髓损伤慢性期患者的泌尿外科治疗]

[Urological treatment of patients with spinal cord injury in the chronic stage].

作者信息

Suemori T, Natsume O, Yamamoto M, Momose H, Okamura K, Shiomi T, Yamada K

机构信息

Department of Urology, Hoshigaoka Koseinenkin Hospital.

出版信息

Hinyokika Kiyo. 1987 Jul;33(7):1070-4.

PMID:3687630
Abstract

One hundred eighty patients with spinal cord injury were admitted to our hospital between January, 1980 and June, 1983. Eighty-five of them had cervical lesions, 54 had thoracic lesions and 41 had lumbar lesions. Most of the neurogenic bladders due to spinal cord injury treated in our clinic, could be classified into 3 major patterns: hypoactive detrusor-hypoactive sphincter, hypoactive detrusor-active sphincter, and hyperactive detrusor-hyperactive sphincter. To control the hyperactivity of the detrusor and the sphincter, we employed pharmacotherapy first and then we performed transurethral resection of the bladder neck and prostatectomy (TUR-Bn.P) and nerve block (sacral nerve block, pudendal nerve block, obturator nerve block and lumbar nerve block). In the case of a hypoactive detrusor, we employed TUR-Bn.P, open ileal flap fixation to the bladder and voiding training. Using these procedures, we could make 157 patients catheter-free.

摘要

1980年1月至1983年6月期间,我院收治了180例脊髓损伤患者。其中85例为颈部损伤,54例为胸部损伤,41例为腰部损伤。我院门诊治疗的大多数脊髓损伤所致神经源性膀胱可分为三大类型:逼尿肌活动低下-括约肌活动低下型、逼尿肌活动低下-括约肌活动亢进型、逼尿肌活动亢进-括约肌活动亢进型。为控制逼尿肌和括约肌的活动亢进,我们首先采用药物治疗,然后进行经尿道膀胱颈切除术和前列腺切除术(TUR-Bn.P)以及神经阻滞(骶神经阻滞、阴部神经阻滞、闭孔神经阻滞和腰神经阻滞)。对于逼尿肌活动低下的情况,我们采用TUR-Bn.P、开放回肠瓣固定于膀胱以及排尿训练。通过这些方法,我们使157例患者无需留置导尿管。

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