膀胱内注射肉毒素治疗膀胱过度活动症的研究进展

Advances in the treatment of overactive bladder by intravesical botulinumtoxin injection

对于M受体阻滞剂治疗无效或不耐受的难治性膀胱过度活动症(OAB)患者,膀胱内注射肉毒素(BTX)是一项安全、有效的治疗手段。BTX膀胱内注射后,通过与神经肌接头处的突触前膜结合,进而阻止前膜释放乙酰胆碱,引起特定肌肉可恢复性的迟缓性麻痹而起到治疗作用。BTX治疗难治性OAB的临床效果已得到广泛验证,且适用于儿童、糖尿病及老年OAB患者。通过分析文献,对注射BTX的适应证及禁忌证,BTX产品种类及用量、注射方法、疗效与影响因素、不良反应及其干预措施等方面进行总结与探讨,以期为BTX注射这一疗法的临床应用提供更详实的参考与指导。

Intravesical botulinumtoxin（ BTX） injection has been proved to be a safe and effective treatment for intractable overactive bladder syndrome（ OAB） that is refractory to antimuscarinics. This review is going to highlight the major progresses of this technique to provide a detailed picture for its clinical applications. The biological properties of BTX and its working mechanisms will be introduced first,and then,the properties of BTX products from different companies,indications and contraindications of this technique,the right injected dosage and appropriate sites of injection,effects and adverse effects will be stated and discussed. Meanwhile,the effects of BTX injection in specific groups of patients like children,diabetes mellitus（ DM） patients and elderly people will be explored.