选择性骶神经前根切断术治疗脊髓损伤后痉挛性膀胱的临床研究(附9例报道)

A clinical study on the treatment of spastic urinary bladder after spinal cord injury by differential sacral nerve anterior root rhizotomy

目的 研究治疗脊髓损伤后痉挛性膀胱的新手术方法。方法 利用骶神经根及骶丛神经相互间代偿的原理 ,设计了选择性骶神经前根切断术 ,治疗 9例脊髓损伤后痉挛性膀胱。结果 9例患者术后膀胱痉挛均明显缓解 ,膀胱贮尿及排尿功能均得到明显改善 ,经 6～ 2 4个月随访 ,其中 8例患者膀胱功能已达到或接近正常水平 ,1例患者膀胱功能恢复略差。结论 选择性骶神经前根切断术治疗脊髓损伤后痉挛性膀胱的疗效显著。

Objective To explore a new method for treatment of spastic urinary bladder after spinal cord injury. Methods According to the principle of the functional compensation between sacral nerve root and sacral plexus ,a new method called differential sacral nerve anterior root rhizotomy was designed to treat spastic bladder after spinal cord injury,9 cases were included in this report.Results The spasticity of urinary bladder was much relieved and the storage and evacuation function of the bladder improved significantly after operation in all 9 cases. After 6-24 months following-up investigation, the bladder function became normal or nearly normal in 8 cases while it was not so satisfactory in only one case. Conclusion Differential sacral nerve anterior root rhizotomy is a good and effective method to treat spastic bladder after spinal cord injury.