隐性骶椎裂致排尿障碍的尿动力学及X线影像学研究

Urodynamic and X-ray studies in patients with occult spinabifida of the sacrum

分析了３１例隐性骶椎裂患者行尿动力学及Ｘ线影像学检查结果。尿动力学显示反射性膀胱１９例，无反射性膀胱１２例；括约肌协同正常１４例，外括约肌协同失调７例，内括约肌协同失调１０例。结果提示：Ｓ１或Ｓ２部位的隐性骶椎裂易引起排尿障碍；隐性骶椎裂部位、程度与排尿障碍表现、神经源膀胱类型无对应关系；隐性骶椎裂致排尿障碍的病理改变是一个慢性长期的过程，病程较长者临床症状较重。作者认为治疗应以纠正逼尿肌与括约肌失衡，改善排尿为目的。

The urodynamic and X ray results of 31 cases of occult spinabifida of the sacrum were analyzed. Urodynamic studies demonstrated that there was a reflex neurogenic bladder in 19 patients and an areflex neurogenic bladder in the other 12. A normal sphincter was observed in 17, asynergia of the external sphincter in 7 and asynergia of the internal sphincter in 10. The spinabifida at S 1 or S 2 might cause easily a neurogenic bladder dysfunction. The result demonstrated that the site and degree of spinabifida did not relate to the type of micturation disorder or to the type of neurogenic bladder. The longer the clinical course is ,the more the symtoms would be. The formation, diagnosis and treatment of the spinabifida, and its relation to the neurogenic bladder were discussed. The aim of its management is to correct the dyssynergia between bladder detrusor and sphincter so as to improve micturation.