脊髓脊膜膨出并发神经源性膀胱的诊疗现状及进展

Current status and advances of diagnosing and treating neurogenic bladder in children with myelomeningocele

脊髓脊膜膨出为一种严重的开放性脊柱裂，其90%以上会并发下尿路功能障碍。泌尿系统并发症是其致死的主原因之一。尿动力学检查可帮助诊断神经源性膀胱，并指导治疗。目前对于脊髓脊膜膨出手术时机的选择仍有争议，宫内手术能否改善下尿路功能仍不肯定。脊髓脊膜膨出并发神经源性膀胱治疗的目标为保护肾功能及提高患儿生活质量，其方法目前主包括保守治疗、外科治疗、神经调节等。

Myelomeningocele is the most common and clinically severe type of open spina bifida defects. And over 90% children are complicated by lower urinary tract dysfunction. As a significant source of mortality, urological issues are implicated as a cause of mortality with myelomeningocele. Urodynamic examination may aid the diagnosis of neurogenic bladder and guide treatment. Currently, the operative timing has remained controversial. Whether in utero procedures improve the function of lower urinary tract is still uncertain. The treatment goal of neurogenic bladder is to protect kidney function and improve children’s quality-of-life. Major treatments include conservative treatment, surgery and neuromodulation.