84例TCS患者的MRI及尿动力学分析

MRI and Urodynamic analyzation of 84 tethered cord syndrome

目的探讨脊髓栓系位置与神经原性膀胱类型的关系及尿动力学检查对神经原性膀胱的诊断价值。方法对84例脊髓栓系合并神经原性膀胱的患者行MRI及尿动力学检查并行分组统计。结果所有患者均合并脊髓栓系,其中脊髓脊膜膨出76例,隐性脊柱裂8例,脊髓栓系位置在S1以上的(55.95%)47例,其中无反射膀胱29(34.52%)例,高反射膀胱18(21.43%)例;S1以下的37(44.05%)例,无反射膀胱21(25.00%)例,高反射膀胱16(19.05%)例。结论脊髓栓系位置与神经原性膀胱的类型无关,尿动力学检查能对神经原性膀胱进行分类,为临床治疗提供客观依据。

Objective To evaluate the relationship between locations of tethered cord and types of neurogenic bladder, meanwhile,the prognostic significance of Urodynamic analyzation for neurogenic bladder is investigated. Methods MRI and Urodynamic examinations were carried out pre and post operation on 84 patients suffered from tethered cord combined whith neurogenic bladder, the clinical data was analyzed by suitable statistic methods. Results All patients were TCS,76 cases were myelomeningocele, 8 cases were spina bifida occuha. The locations of tethered cord above S1 were 47 cases （ 55.95% ）, of which 29 （ 34.52% ） cases were areflexia bladder, 18 （ 21.43% ） cases were hyperreflexia bladder. By contrast ,of the 37（44.05% ） cases locations of tethered cord below S1 ,21 （25.00%） cases were areflexia, 16 （ 19.05% ） were hyperreflexia. Conclusions The locations of tethered cord were not correlated with the types of neurogenic bladder. Urodynamic analyzation is capable for diagnosing the subtypes of neurogenic bladder and providing objective proof for clinical treatment.