脂肪脊髓脊膜膨出患儿手术前后的尿动力学及体感诱发电位监测评价

Evaluation of Urodynamic Study and Somatosensory Evoked Potentials before and after Operation in Children with Lipomyelomeningocele

目的研究脂肪脊髓脊膜膨出(LMMC)患儿手术前后的尿动力学(UDS)和体感诱发电位(SEPs)监测评估的意义。方法LMMC患儿31例,早期行显微手术并重建硬脊膜,手术前后进行UDS和SEPs检查,测定膀胱容量、剩余尿量、顺应性、灌注末期最大逼尿肌压、SEPs潜伏期及波幅等数据。结果UDS和SEPs相关指标术前手术组与对照组、手术组手术前后及术后临床改善组与无效果组术前比较均有明显统计学意义。结论UDS和SEPs检查是指导LMMC治疗和评价疗效的客观指标。术前UDS/SEPs检查异常较明显病例应避免手术中过多操作。

Objective To evaluate prourodynamic study and somatosensory evoked potentials （SEPs） before and after operation of children with lipomyelomeningocele（LMMC） and its clinical significance. Methods Urodynamic study（ UDS）and SEPs in 31 cases of LMMC who underwent microsurgical release within 1 week preoperatively and 3 months postoperatively were conducted. The 4 parameters used for UDS evaluation were bladder volume,compliance,detrusor activity and residual urine;parameters used for SEPs evaluation were latent period and amplitude. Resuits There was a statistics significant difference between operation and control group;the similar result was attented in the comparison of before and after operation,also in the comprison of the improved group and the group without improvement after operation. Conclusions UDS and SEPs investigation can provide guidance for the treatment of tethered cord syndrome（TCS） and evaluate clinical prognosis. These cases with the severity changing in UDS and somatosensory shall be avoided unnecessary action in operation.