Curt A, Rodic B, Schurch B, Dietz V
Swiss Paraplegic Centre, University Hospital Balgrist, Zürich, Switzerland.
Spinal Cord. 1997 Jun;35(6):368-73. doi: 10.1038/sj.sc.3100423.
The significance of the ASIA (American Spinal Injury Association) scores and SSEP (somatosensory evoked potentials) recordings in predicting the recovery of bladder function was evaluated in 70 patients with acute, traumatic spinal cord injury (SCI). The patients were examined following admission to the rehabilitation centre (mean 10 days post-trauma) both clinically by the ASIA scores and electrophysiologically by tibial and pudendal SSEP recordings. The results of the initial examinations were related to the degree of recovery of bladder function of the patients assessed by urodynamic examination at the end of the rehabilitation programme (at least 6 months post-trauma). The recovery of somatic nerve function (external urethral sphincter function) involved in bladder function was correlated to both the initial ASIA scores and SSEP recordings (Spearman correlation, P < 0.001). The latter parameters, however, were not related to the outcome of autonomic nerve function (eg detrusor vesicae function) (Spearman correlation, P = 0.1). Therefore, the initial clinical and electrophysiological examinations are of value in assessment of the degree to which the patient will recover somatic nervous control of bladder function. However, these examinations are not indicative of urodynamic impairment. Therefore, urodynamic examination should be mandatory for the diagnostic assessment and therapeutical approach of bladder dysfunction in patients with acute SCI.
在70例急性创伤性脊髓损伤（SCI）患者中，评估了美国脊髓损伤协会（ASIA）评分和体感诱发电位（SSEP）记录在预测膀胱功能恢复方面的意义。患者在入住康复中心后（创伤后平均10天）接受检查，通过ASIA评分进行临床评估，并通过胫神经和阴部神经SSEP记录进行电生理评估。初始检查结果与康复计划结束时（创伤后至少6个月）通过尿动力学检查评估的患者膀胱功能恢复程度相关。膀胱功能所涉及的躯体神经功能（尿道外括约肌功能）的恢复与初始ASIA评分和SSEP记录均相关（Spearman相关性，P<0.001）。然而，后述参数与自主神经功能（如膀胱逼尿肌功能）的结果无关（Spearman相关性，P = 0.1）。因此，初始临床和电生理检查对于评估患者膀胱功能的躯体神经控制恢复程度具有价值。然而，这些检查并不能提示尿动力学损害。因此，对于急性SCI患者膀胱功能障碍的诊断评估和治疗方法，尿动力学检查应是必不可少的。
