神经假体移植与神经源性膀胱

Neuroprostheses and neurogenic bladder

背景:脊髓损伤后由于神经传导通路中断,膀胱失去正常调控,经常出现尿潴留及肾损害,其膀胱功能重建一直是神经泌尿外科学研究的难点之一,神经假体移植被认为是重建其功能的有效手段。目的:探讨近年来应用神经假体移植治疗脊髓损伤后神经源性膀胱的最新进展。方法:应用计算机检索CNKI和springer数据库中1988-01/2009-12关于神经假体移植治疗神经源性膀胱的文章,在标题和摘要中以"神经假体,移植,治疗,神经源性膀胱,电刺激"或"Neuroprostheses,Implantion,Treat,Neurogenic bladder,Electrical stimulation"为检索词进行检索。选择文章内容与神经假体移植治疗神经源性膀胱相关并发表在权威杂志上。根据纳入标准选择44篇文章进行综述。结果与结论:目前脊髓再生研究尚无重大进展的情况下,神经假体移植技术逐渐成为重建脊髓损伤后神经功能的主要手段。当前临床上治疗神经源性膀胱的神经假体有2种:一是Finetech-Brindley膀胱系统,另一种是InterStim-Therapy膀胱系统。近年来4种新技术的开展将对神经假体治疗神经源性膀胱带来革命性变化:①阳极阻滞技术。②条件性电刺激。③注射型神经假体。④刺激阴部神经分支。

BACKGROUND：Due to interrupt of neural pathway after spinal cord injury,bladder loss normal control,and lead to urinary retention or renal damage.The reconstruction of bladder function has been the difficulty of the nervous urology.Neuroprostheses transplantation is considered an effective method to reconstruct functions. OBJECTIVE：To investigate the latest development of neuroprostheses for the treatment of neurogenic bladder after spinal cord injury.METHODS：CNKI and springer database were searched by computer for papers related to neuroprostheses for the treatment of neurogenic bladder after spinal cord injury published from January 1988 to December 2009.In the title and summary,＂neuroprostheses,implantion,treat,neurogenic bladder,electrical stimulation＂ were served as key words.These articles were linked to neuroprostheses transplantation to treat neurogenic bladder and published in the authoritative journal were selected.Totally 44 articles were included according to the inclusive criteria. RESULTS AND CONCLUSION：At present,there is no significant progress in spinal cord regeneration.Neurolprostheses has become the primary means to reconstruction nerve function.There are two neuroprostheses to treat neurogenic bladder in clinical：one is Finetech-Brindley bladder system,the other is InterStim-Therapy bladder system.In recent years,the launch of four new technology bring revolutionary changes to neurogenic bladder treatment,including：anoda blocking technique,conditional electrical stimulation,injectable neuroprostheses and electrical stimulate the pudendal nerve branches.