Selzman A A, Elder J S, Mapstone T B
Department of Pediatric Urology, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio.
Urol Clin North Am. 1993 Aug;20(3):485-504.
Spina bifida and other congenital abnormalities of the spinal cord are relatively common (1 per 1000 births). Early urologic evaluation to determine the extent of neurologic involvement of the lower urinary tract is essential. Urodynamic studies are important in determining voiding pressure and leak pressure and in classifying the type of detrusor and sphincter dysfunction. Therapy is directed toward preservation of the upper tracts. Many nonsurgical (clean intermittent catheterization and anticholinergic drugs) and surgical procedures allow the child to be continent and maintain a normal upper urinary tract. The importance of follow-up is stressed because neurourologic changes frequently occur, and prompt treatment or change of therapy is essential. Today, children with spina bifida are leading healthy, productive lives. A continued multidisciplinary approach to their care is important.
脊柱裂和其他脊髓先天性异常相对常见（每1000例出生中有1例）。早期进行泌尿外科评估以确定下尿路神经受累程度至关重要。尿动力学研究对于确定排尿压力和漏尿压力以及对逼尿肌和括约肌功能障碍类型进行分类很重要。治疗旨在保护上尿路。许多非手术方法（清洁间歇性导尿和抗胆碱能药物）和手术程序可使患儿实现控尿并维持正常的上尿路。强调随访的重要性，因为神经泌尿系统变化经常发生，及时治疗或改变治疗方法至关重要。如今，患有脊柱裂的儿童正过着健康、有意义的生活。持续采用多学科方法进行护理很重要。
