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腰椎疾病后神经源性膀胱的病理生理学、评估与管理

Neurogenic bladder pathophysiology, assessment and management after lumbar diseases.

作者信息

Hao Jiayu, Jiang Jian, Han Qiaoyue, Wang Kui, Sun Yuefeng, Wang Hong

出版信息

EFORT Open Rev. 2025 Mar 3;10(3):156-165. doi: 10.1530/EOR-24-0087. Print 2025 Mar 1.

Abstract

Neurogenic bladder (NB) is a group of bladder and/or urethral dysfunctions caused by neurological lesions, commonly seen in patients with lumbar spine diseases, manifesting as urinary storage and voiding dysfunction, significantly affecting patients' quality of life. Degenerative changes or trauma to the lumbar spine can lead to narrowing of the dural sac, compressing the sacral nerve roots, cauda equina or blood vessels, causing bladder dysfunction and leading to NB. Diagnostic methods for NB include history taking, physical examination and noninvasive and invasive tests, such as urodynamic testing and cystoscopy. The treatment goals for NB are to protect upper urinary tract function, restore or partially restore lower urinary tract function, improve urinary control, reduce residual urine volume, prevent urinary tract infections and improve patients' quality of life. Treatment methods include conservative treatment, pharmacological treatment, catheterization, neuromodulation and surgical treatment, which should be sequentially administered based on the patient's specific condition.

摘要

神经源性膀胱(NB)是一组由神经病变引起的膀胱和/或尿道功能障碍,常见于腰椎疾病患者,表现为储尿和排尿功能障碍,严重影响患者的生活质量。腰椎的退行性改变或创伤可导致硬膜囊狭窄,压迫骶神经根、马尾或血管,引起膀胱功能障碍并导致神经源性膀胱。神经源性膀胱的诊断方法包括病史采集、体格检查以及无创和有创检查,如尿动力学检查和膀胱镜检查。神经源性膀胱的治疗目标是保护上尿路功能,恢复或部分恢复下尿路功能,改善控尿能力,减少残余尿量,预防尿路感染并提高患者的生活质量。治疗方法包括保守治疗、药物治疗、导尿、神经调节和手术治疗,应根据患者的具体情况依次进行。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6de0/11896685/0dce8e19dcf9/EOR-2024-0087fig1.jpg

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