A型肉毒毒素治疗神经源性尿潴留21例临床观察

The Efficacy of Botulinum Toxin Type A Treatment to Neurogenic Bladder Urinary Retention

目的:观察A型肉毒毒素治疗神经源性尿潴留的疗效,不良反应和有效时间。方法:收集21例神经疾病后尿潴留患者,A型肉毒毒素尿道外括约肌注射,记录治疗前后症状,尿流动力学指标,综合评估A型肉毒毒素治疗神经源性尿潴留的疗效,并记录不良反应和有效时间。结果:A型肉毒毒素治疗神经源性尿潴留,患者症状可明显改善,生存质量评分和国际下尿路综合征症状评分明显改善,尿流动力学指标明显改善,未见明显不良反应,疗效可维持(3±1)(1～5)个月。结论:A型肉毒毒素尿道外括约肌注射是一种治疗神经源性尿潴留的有效方法,短期内对部分患者能够显著改善排尿症状,提高生存质量,且未见不良反应。

Objective：To evaluate the efficacy , adverse reaction and effective time of botulinum toxin TypeA （BTX-A）treatment to neurogenic bladder urinary retention. Methods：21 patients with neurogenic bladder urinary retention were injected 200 U of BTX-A dissolved in 8 mL of saline into 8 different points, with 25 U for each point. Urinary dynamic（UD） tests were performed and adverse effects were observed; The symptoms of voiding before and after treatment were recorded. Results：AH the patients were followed for 6 months. Urinary dynamic （UD）tests and the symptoms of voiding were significantly improved, there were significant changing in scores of Quality of I.ife（QOL） and lower urinary tract syndrome （LUTS）. No systematic or local adverse effects associated with BTX-A occurred. Conclusions：External sphincter injections of BTX-A is an effective therapy for neurogenic bladder urinary retention due to a variety of causes, significantly improving symptoms and quality of life in some patients over a short term.