膀胱三角区联合逼尿肌注射A型肉毒毒素治疗小儿神经源性逼尿肌过度活动伴尿失禁的疗效和安全性

Efficacy and safety of trigone- detrusor injection of botulinum toxin in children with neurogenic detrusor overactivity and incontinence

目的观察膀胱三角区联合逼尿肌注射A型肉毒毒素(BTX-A)治疗小儿神经源性逼尿肌过度活动(NDO)伴尿失禁的疗效,并评价其安全性。方法将75例NDO伴尿失禁患儿随机分为两组,对照组(n=37)仅于逼尿肌注射BTX-A,观察组(n=38)于逼尿肌注射BTX-A,同时于膀胱三角区注射BTX-A。比较两组的临床效果和安全性。结果观察组的尿失禁生命质量评分高于对照组(P<0.05),观察组的尿失禁患儿例数低于对照组(P<0.05),观察组的储尿期膀胱逼尿肌最大压力减少值优于对照组(P<0.05)。两组不良事件发生率无显著差异(P>0.05)。结论膀胱三角区联合逼尿肌注射BTX-A治疗小儿NDO伴尿失禁的疗效确切,且安全性较高。

Objective To observe the efficacy and safety of trigone- detrusor injection of botulinum toxin A（ BTX- A） in children with neurogenic detrusor overactivity（ NDO） and urinary incontinence. Methods 75 cases of NDO associated with incontinence were randomly divided into control group（ n = 37） and observation group（ n = 38）. BTX- A was only injected in detrusor in control group,BTX- A was injected in both detrusor and trigone in observation group. The clinical effect and safety were compared between two groups. Results The incontinence quality of life score in observation group was higher than control group（ P〈0. 05）,and urinary incontinence cases in observation group was less than control group（ P〈0. 05）. The maximum detrusor pressure in observation group was significantly decreased in comparison with that in control group（ P〈0. 05）. There was no difference in the incidence of adverse events between the 2 groups（ P〉0. 05）. Conclusion Trigone-detrusor injection of BTX- A is effective and safe for the treatment of pediatric NDO associated with incontinence.