Cardenas D D, Kelly E, Mayo M E
Arch Phys Med Rehabil. 1985 Jul;66(7):459-62.
Thirty-four urodynamic studies were performed in 20 patients with spinal cord injury (SCI) to determine the most effective triggering mechanism for reflex voiding. The studies were performed at a time when the patient was normally scheduled for catheterization, which avoided stimulation of the detrusor and sphincter by bladder filling via a catheter. The three methods chosen were used in a random sequence. Suprapubic tapping and jabbing were equally effective in producing a rise in detrusor pressure, and the sphincter responses were almost identical. Cutaneous stimulation of the thigh rarely produced any change in detrusor and sphincter activity. When detrusor contractions were produced, a dyssynergic sphincter response prevented voiding in 46% of the studies; however, voiding always occurred when the sphincters were either coordinated or showed no change. Both tapping and jabbing were more effective as the time from injury increased, which reflects the natural recovery from spinal shock.
对20例脊髓损伤（SCI）患者进行了34次尿动力学研究，以确定反射性排尿最有效的触发机制。这些研究在患者正常安排导尿的时间进行，避免了通过导尿管膀胱充盈对逼尿肌和括约肌的刺激。所选择的三种方法按随机顺序使用。耻骨上轻敲和戳刺在使逼尿肌压力升高方面同样有效，且括约肌反应几乎相同。大腿皮肤刺激很少引起逼尿肌和括约肌活动的任何变化。当产生逼尿肌收缩时，在46%的研究中，不协调的括约肌反应阻止了排尿；然而，当括约肌协调或无变化时总是会发生排尿。随着受伤时间的增加，轻敲和戳刺都更有效，这反映了脊髓休克后的自然恢复。
