神经原性膀胱的评价和对策

Evaluation and arrangement of neuropathic bladder

排尿机制较为复杂 ,不同部位的脊髓损伤会造成不同类型的神经原性膀胱。尿流动力学技术是评判膀胱功能的重要手段 ,其主要指标有尿流率、膀胱压力容积测定及同步的括约肌肌电图等。在充分了解神经原性膀胱病理生理特点的基础上 ,可应用不同的治疗方法改善膀胱功能。这些方法包括药物治疗、骶神经电刺激法、括约肌切开术、选择性骶神经切断术等。治疗目的是改善膀胱的功能 ,消除其对肾功能的威协 ,提高患者的生活质量。

The mechanisms of micturation are rather complex,so that thedifferent types of neuropathic bladder will be caused by spinal cord injury in different position.Urodynamics is an important method to evaluate bladder function .It includes uroflowmetry,cystometry and synchronic electromyography of pelvic floor etc .Pathophysiologic feature of neuropathic bladder can be fully demonstrated by urodynamic means and many measures of treatment can be selected according to its results.These measures of treatment include medicine therapy ,sacral roots electrostimulation , spincterotomy and selected sacral dorsal rhizotomy etc.The aim of treatment is to improve bladder function, eleminate threat to renal function and enhance quality of life .