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脊髓损伤后神经源性下尿路功能障碍

[Neurogenic lower urinary tract dysfunction following spinal cord injury].

作者信息

Kaufmann Albert

机构信息

Neuro-Urologie, Schweizer Paraplegiker-Zentrum, Guido A. Zäch-Straße 1, 6207, Nottwil, Schweiz.

出版信息

Urologie. 2025 Feb;64(2):108-119. doi: 10.1007/s00120-024-02494-1. Epub 2025 Jan 12.

Abstract

A spinal cord injury (SCI) leads to neurogenic lower urinary tract dysfunction (NLUTD), which, if left untreated, can result not only in urinary incontinence and an increased risk of urinary tract infections and kidney dysfunction but may also pose a vital threat to people with SCI. Comprehensive neurourological assessments, including patient history and combined video urodynamics, are essential to accurately classify dysfunction and establish therapeutic strategies. Treatment options include, among others, medications for detrusor regulation, intermittent catheterization, and, if necessary, surgical interventions from intradetrusor botulinum toxin A injections to sacral deafferentation. An interdisciplinary approach and lifelong follow-up care are crucial for enhancing patients' quality of life and minimizing the risk of urological complications.

摘要

脊髓损伤(SCI)会导致神经源性下尿路功能障碍(NLUTD),如果不加以治疗,不仅会导致尿失禁、尿路感染风险增加和肾功能障碍,还可能对脊髓损伤患者构成重大威胁。全面的神经泌尿学评估,包括患者病史和联合影像尿动力学检查,对于准确分类功能障碍和制定治疗策略至关重要。治疗选择包括,除其他外,用于调节逼尿肌的药物、间歇性导尿,以及必要时从膀胱内注射肉毒杆菌毒素A到骶神经去传入手术等外科干预措施。跨学科方法和终身随访护理对于提高患者生活质量和降低泌尿系统并发症风险至关重要。

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