骶神经调控术在小儿神经源性膀胱治疗中的应用进展

Research advances of sacral neuromodulation in the management of pediatric neurogenic bladder

小儿神经源性膀胱(PNB)是指脊髓发育不良、脊髓神经损伤导致膀胱逼尿肌或(和)尿道括约肌功能障碍,表现为排尿障碍或伴有排便障碍,严重影响患者的生活质量。骶神经调控(SNM)的主要适应证是膀胱过度活动综合征,症状包括顽固性尿频、尿急、急迫性尿失禁、非梗阻性尿潴留,推荐SNM的适宜年龄为16岁以上。研究表明SNM对改善顽固性膀胱功能和排便功能障碍效果显著。本文就骶神经调控在小儿神经源性膀胱治疗中的应用进展进行回顾,为该项技术在小儿神经源性膀胱人群中的开展提供参考。

Pediatric neurogenic bladder(PNB)is defined as dysfunction of the detrusor and/or urethral sphincter due to myelodysplasia or spinal cord injury,manifesting as impaired urination or defecation,which seriously affects the patients'quality of life.The main indication for sacral neuromodulation(SNM)is overactive bladder syndrome,which presents as refractory urinary frequency and urgency,urgency incontinence and non-obstructive urinary retention.Age more than 16 years are also recommended for this technique.Previous studies have revealed that SNM could significantly improve the outcome of refractory bladder bowel dysfunction.This paper reviews the advances of the application of SNM in the treatment of pediatric neurogenic bladder so as to provide reference for pediatricians.