儿童脂肪脊髓脊膜膨出不同类型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 Various Types of Lipomyelomeningocele

目的通过尿流动力学(UDS)和体感诱发电位(SEPs)的监测评估,研究脂肪脊髓脊膜膨出(LMMC)不同类型手术效果。方法 LMMC患儿93例,行显微手术并重建硬脊膜,手术前后进行尿流动力学和体感诱发电位检查,测定膀胱容量、剩余尿量、顺应性、灌注末期最大逼尿肌压;SEPs的潜伏期、波幅等数据。结果Ⅰ型(尾型)、Ⅱ型(背侧型)和Ⅲ型(混合型)尿流动力学和体感诱发电位相关指标术前、术后比较均有明显的统计学意义。结论Ⅰ型(尾型)和Ⅱ型(背侧型)Ⅲ型(混合型)早期成功手术均能一定程度上改善脂肪脊髓脊膜膨出患儿生存质量。

Objective To evaluate urodynamic study（UDS）and somatosensory evoked potentials（SEPs）before and after operation of children with various types of lipomyelomeningocele（LMMC）and its results.Methods We conducted urodynamic study（UDS）and SEPs in 93 cases of LMMC who underwent microsurgical release within 1 week preoperatively and 3 months postoperatively.The three parameters used for UDS evaluation were bladder volume, Compliance and detrusor activity;Parameters used for SEPs evaluation were latent period and amplitude.Results There were statistics significant difference between the comparison of fore-and-aft operation of typeⅠ,also in the comparison of the typeⅡand typeⅢ.Conclusion Early and appropriate operation for any type of lipomyelomeningocele was required and effective.