脊髓损伤后神经源性膀胱康复治疗进展

The review of rehabilitation treatment for neurogenic bladder after spinal cord injury

神经源性膀胱是脊髓损伤(SCI)的临床常见合并症之一。膀胱功能障碍引起的肾功能衰竭是脊髓损伤患者死亡的第一位原因。因此,重建脊髓损伤患者的膀胱功能,是脊髓损伤患者康复治疗中一项重要内容。脊髓损伤后神经源性膀胱康复治疗方法主要包括保守治疗和外科治疗,但目前仍是主要以保守治疗为主。尿流动力学检查已成为脊髓损伤后膀胱尿道功能障碍的常规检查技术,通过尿流动力学检查可对膀胱尿道功能进行分类外,还可为临床的诊断、治疗及疗效评价提供更多的客观指标。本文结合尿流动力学理论就近些年来脊髓损伤后神经源性膀胱康复治疗研究的成果进行概述,总结出脊髓损伤后神经源性膀胱的治疗是复杂的综合工作,治疗的前提是必须明确其尿流动力学特点,间歇性导尿、膀胱功能训练等已经是比较成熟的治疗手段,但目前仍没有一种方法可以使神经源性膀胱功能完全恢复。

Neurogenic bladder is one of clinical common complication of spinal cord injury. To improve the patients quality of life and reduce mortality, reconstruction of spinal cord injury patients with bladder function has important significance. Neurogenic bladder after spinal cord injury rehabilitation method is numerous, but conservative treatment is given priority to the most patients, which specific method to be choosed depends on the type of patients with neuro genic bladder dysfunction.Urodynamic testing has become a routine inspection of bladder dysfunction after spinal cord injury, neurogenic bladder can be categorize through the test, besides ,it still can provide more objective indicators of clinical diagnosis, treatment and curative effect evaluation. Reconstruction of spinal cord injury patients with bladder function is one of the hot problems in spinal cord injury rehabilitation medicine. This article is to summarize the latest research results of rehabilitation in spinal cord injury combined with urodynamic testing.Various treatments for neuro getic bladder were introduced and their treatment results were critically reviewed. Summarily, the treatment of neuro genic bladder after spinal cord injury is an integrated and complex work, which no satisfying treatment is available. Bladder function training and intermittent catheterization are common method.