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Very Low, Real-Time Rate of Urinary Retention after Intradetrusor Botox<sup>&reg</sup>for Non-Neurogenic Overactive Bladder
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作者 Kirin K. Syed Christopher S. Gomez Angelo E. Gousse 《Open Journal of Obstetrics and Gynecology》 2017年第8期915-921,共7页
Introduction: According to the most recent AUA/SUFU guidelines, intradetrusor onabotulinumtoxinA (BTN/A) is a standard, evidence strength grade B, third line treatment option for refractory non-neurogenic overactive b... Introduction: According to the most recent AUA/SUFU guidelines, intradetrusor onabotulinumtoxinA (BTN/A) is a standard, evidence strength grade B, third line treatment option for refractory non-neurogenic overactive bladder (OAB). Urinary retention is the most common clinically significant reported side effect ranging from 5.4% to 43% in previous studies. The aim of this study was to investigate the real-time rate of urinary retention in patients treated with BTN/A for refractory non-neurogenic OAB in a multi-institutional study. Methods: Retrospective chart review identified 71 patients who were treated with 100U BTN/A for refractory non-neurogenic OAB from August 2011 to July 2015 at two institutions. Using a flexible cystoscope, 100U Botox&reg reconstituted with 10 ml normal saline was administered. Injections of 1 ml (10 units/ mL) were administered in 10 evenly distributed sites sparing the trigone. Pre and post BTN/A post-void residuals (PVR) were reviewed. Urinary retention was defined as PVR > 200 mL requiring clean intermittent catheterization (CIC). Results: After exclusion, the study group consisted of 66 patients with a mean age of 67 years and 30% were men. Mean pre and post-procedural PVR were 14.06 mL and 69.21 mL. Eight patients (12.12%) were noted to have elevated PVR > 200 mL post injection however only one patient (female) required initiation of CIC. The rate of urinary retention was 1.5% (N = 1). There was no correlation with age, history of previous radiation, diabetes or prior use of a neuromodulator device. Conclusions: To the best of our knowledge, this is the first study to demonstrate a very low risk of real-time urinary retention rates in appropriately selected patients treated with BTN/A for refractory non-neurogenic OAB outside of a clinical trial setting. 展开更多
关键词 Intradetrusor OnabotulinumtoxinA Refractory Non-neurogenic Overactive bladder urinary RETENTION OAB urinary RETENTION RATE Botox®
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Survey of spinal cord injury-induced neurogenic bladder studies using the Web of Science 被引量:3
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作者 Benjing Zou Yongli Zhang +8 位作者 Yucheng Li Zantao Wang Ping Zhang Xiyin Zhang Bingdong Wang Zhixin Long Feng Wang Guo Song Yan Wang 《Neural Regeneration Research》 SCIE CAS CSCD 2012年第23期1832-1839,共8页
OBJECTIVE:To identify global trends in research on spinal cord injury-induced neurogenic bladder, through a bibliometric analysis using the Web of Science. DATA RETRIEVAL:We performed a bibliometric analysis of stud... OBJECTIVE:To identify global trends in research on spinal cord injury-induced neurogenic bladder, through a bibliometric analysis using the Web of Science. DATA RETRIEVAL:We performed a bibliometric analysis of studies on spinal cord injury-induced neurogenic bladder using the Web of Science.Data retrieval was performed using key words"spinal cord injury","spinal injury","neurogenic bladder","neuropathic bladder","neurogenic lower urinary tract dysfunction","neurogenic voiding dysfunction","neurogenic urination disorder"and "neurogenic vesicourethral dysfunction". SELECTION CRITERIA:Inclusion criteria:(a)published peer-reviewed articles on spinal cord injury-induced neurogenic bladder indexed in the Web of Science;(b)type of articles:original research articles and reviews;(c)year of publication:no limitation.Exclusion criteria:(a)articles that required manual searching or telephone access;(b)Corrected papers and book chapters. MAIN OUTCOME MEASURES:(1)Annual publication output;(2)distribution according to journals; (3)distribution according to subject areas;(4)distribution according to country;(5)distribution according to institution;and(6)top cited publications. RESULTS:There were 646 research articles addressing spinal cord injury-induced neurogenic bladder in the Web of Science.Research on spinal cord injury-induced neurogenic bladder was found in the Science Citation Index-Expanded as of 1946.The United States,Ireland and Switzerland were the three major countries contributing to studies in spinal cord injury-induced neurogenic bladder in the 1970s.However,in the 1990s,the United States,the United Kingdom,the Netherlands,Germany and Japan published more papers on spinal cord injury-induced neurogenic bladder than Switzerland,and Ireland fell off the top ten countries list.In this century,the United States ranks first in spinal cord injury-induced neurogenic bladder studies,followed by France,the United Kingdom,Germany,Switzerland and Japan.Subject categories including urology, nephrology and clinical neurology,as well as rehabilitation,are represented in spinal cord injury-induced neurogenic bladder studies. CONCLUSION:From our analysis of the literature and research trends,we conclude that spinal cord injury-induced neurogenic bladder is a hot topic that will continue to generate considerable research interest in the future. 展开更多
关键词 spinal cord injury neurogenic bladder neurogenic lower urinary tract dysfunction neurogenic urination disorder neurogenic vesicourethral dysfunction URODYNAMICS Web of Science neural regeneration
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Impact of Adjuvant Radiotherapy and Reversibility of Neurogenic Bladder on Bladder Storage Function and Impact of Urethral Resistance on Bladder Emptying Function after Radical Hysterectomy 被引量:1
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作者 Noritoshi Sekido Takayuki Yoshino +5 位作者 Eiichiro Takaoka Natsui Waku Ken Tanaka Hiroyuki Nishiyama Hiroyuki Ochi Toyomi Satoh 《Open Journal of Urology》 2017年第12期252-265,共14页
Purpose: To clarify which patients need careful neurourological management after abdominal radical hysterectomy (RH) by investigating the effects of adjuvant radiotherapy and reversibility of neurogenic bladder (NB) o... Purpose: To clarify which patients need careful neurourological management after abdominal radical hysterectomy (RH) by investigating the effects of adjuvant radiotherapy and reversibility of neurogenic bladder (NB) on the storage function as well as the effects of urethral resistance on the emptying function. Methods: Data from sixty-two patients referred to our NB clinic after RH were retrospectively reviewed. Findings of urodynamic studies performed at 3 (UDS-1) and 12 (UDS-2) months after treatment were compared, and logistic analysis was used to calculate the odds ratio (OR) of the effects of radiotherapy and irreversible NB on decreased bladder capacity and decreased compliance. Irreversible NB was defined as the need for clean intermittent catheterization at the last follow-up. Results: At the median follow-up period of 41 months, 60% of the patients continued to require clean intermittent catheterization. Of patients with irreversible NB and radiotherapy, 80% had decreased bladder capacity and decreased compliance at UDS-2. For decreased bladder capacity and decreased compliance, ORs of adjuvant radiotherapy at UDS-2 were 38.42 (p Conclusions: Careful neurourological follow-up after RH is mandatory for patients who undergo adjuvant radiotherapy and have irreversible NB with impaired urethral relaxation. 展开更多
关键词 urinary bladder neurogenic Clean Intermittent CATHETERIZATION HYSTERECTOMY Radiotherapy
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Outcomes of seromuscular bladder augmentation compared with standard bladder augmentation in the treatment of children with neurogenic bladder
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作者 Xiao-Gang Sun Yan-Xia Li +3 位作者 Long-Fei Ji Jia-Long Xu Wei-Xiu Chen Ruo-Yi Wang 《World Journal of Clinical Cases》 SCIE 2022年第23期8115-8123,共9页
BACKGROUND Intestinal seromuscular bladder augmentation(SMBA)surgery has produced no mucosal-related complications,but its outcomes need to be studied.AIM To evaluate the safety and effectiveness of SMBA in the treatm... BACKGROUND Intestinal seromuscular bladder augmentation(SMBA)surgery has produced no mucosal-related complications,but its outcomes need to be studied.AIM To evaluate the safety and effectiveness of SMBA in the treatment of children with neurogenic bladder.METHODS A retrospective analysis of the clinical data of children with SMBA was performed from March 2008 to February 2018,and the data were compared with those of children receiving standard cystoplasty(SC).RESULTS In a cohort of 67 children who underwent bladder augmentation,the 46 children in the SC group had an average age of 10.6 years and a follow-up time of 36 mo,and the 21 children in the SMBA group had an average age of 7.6 years and a follow-up time of 29.7 mo.The preoperative and postoperative bladder volumes in the SMBA group were 151.7 mL and 200.4 mL,respectively,and those in the SC group were 173.9 mL and 387.0 mL,respectively.No significant difference in preoperative urinary dynamic parameters was found between the two groups,but the difference after operation was statistically significant.The main complications after SMBA were residual ureteral reflux and failed bladder augmentation,with incidences of 33.3%and 28.6%,respectively.In all 6 patients with failed augmentation in the SMBA group,ileum seromuscular patches were used for augmentation,and SC was chosen for reaugmentation.During reoperation,patch contracture and fibrosis were observed.CONCLUSION The improvement of urinary dynamic parameters in the SMBA group was significantly lower than that in the SC group.Children with SMBA had a higher probability of patch contracture and reaugmentation,which might be related to impaired blood supply and urine stimulation,and the sigmoid colon patch should be the priority. 展开更多
关键词 neurogenic bladder Seromuscular bladder augmentation bladder SURGERY urinary dynamic parameter
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Translation of basic science into clinical medicine in man-agement for neurogenic bladder
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作者 Limin Liao Guoqing Chen Fan Zhang 《Journal of Translational Neuroscience》 2016年第1期32-36,共5页
Neurogenic bladder ( NB) dysfunction caused by spinal cord injury ( SCI ) or diseases of the central nervous system or peripheral nerves is a major medical and social problem. Traditional treatments to NB include ... Neurogenic bladder ( NB) dysfunction caused by spinal cord injury ( SCI ) or diseases of the central nervous system or peripheral nerves is a major medical and social problem. Traditional treatments to NB include medication, injection of Botulinum toxin A into the detrusor, neuromodulation and surgery. There are also emerging approaches, such as tissue engineering, stem cell transplantation and gene therapy. In recent years, we have carried out explorations in both therapeutic areas and tried to translate basic research into clinical practice. This paper reviews our work in this regard, and provides references for future research. 展开更多
关键词 neurogenic bladder NB MEDICATION urinary tract reconstruction NEUROMODULATION stem cell transplantion gene therapy
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Tanshinone ⅡA improves functional recovery in spinal cord injury-induced lower urinary tract dysfunction 被引量:9
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作者 Yong-dong Yang Xing Yu +2 位作者 Xiu-mei Wang Xiao-hong Mu Feng He 《Neural Regeneration Research》 SCIE CAS CSCD 2017年第2期267-275,共9页
Tanshinone ⅡA, extracted from Salvia miltiorrhiza Bunge, exerts neuroprotective effects through its anti-inflammatory, anti-oxidative and anti-apoptotic properties. This study intravenously injected tanshinone ⅡA 20... Tanshinone ⅡA, extracted from Salvia miltiorrhiza Bunge, exerts neuroprotective effects through its anti-inflammatory, anti-oxidative and anti-apoptotic properties. This study intravenously injected tanshinone ⅡA 20 mg/kg into rat models of spinal cord injury for 7 consecutive days. Results showed that tanshinone ⅡA could reduce the inflammation, edema as well as compensatory thickening of the bladder tissue, improve urodynamic parameters, attenuate secondary injury, and promote spinal cord regeneration. The number of hypertrophic and apoptotic dorsal root ganglion(L6–S1) cells was less after treatment with tanshinone ⅡA. The effects of tanshinone ⅡA were similar to intravenous injection of 30 mg/kg methylprednisolone. These findings suggested that tanshinone ⅡA improved functional recovery after spinal cord injury-induced lower urinary tract dysfunction by remodeling the spinal pathway involved in lower urinary tract control. 展开更多
关键词 nerve regeneration spinal cord injury tanshinone IIA spinal pathway lower urinary tract dysfunction neurogenic bladder dorsal root ganglion detrusor-sphincter dyssynergia urodynamics neural regeneration
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The treatment of urinary retention of neurogenic bladder of one patient with diabetes from the perspective of governor vessel:A case report 被引量:2
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作者 Min YANG Chengcheng XU +2 位作者 Zhilan HUANG Yuanyuan LU Zhizhong RUAN 《World Journal of Acupuncture-Moxibustion》 CSCD 2018年第1期63-65,I0009,共4页
Objective: To report the clinical effect of traditional acupuncture and moxibustion in the treatment of neurogenic bladder.Methods: A single case of a 57-year-old female with neurogenic bladder retention of urine co... Objective: To report the clinical effect of traditional acupuncture and moxibustion in the treatment of neurogenic bladder.Methods: A single case of a 57-year-old female with neurogenic bladder retention of urine considering governor vessel in the use of acupuncture and moxibustion. Acupoints selected: Shenshū(肾俞BL 23),Pángguāngshū(膀胧俞 BL 28). Yāoyángguan(腰阳关GV 3), Mìngmén(命门 GV 4). Moxibustion was applied on Guānyuán(关元 CV4) at the same time.Results: After 6 times of treatment, the patient’s urination function return to normal, avoid the adverse effect of retention catheterization.Conclusion: It is suggested that the combination of acupuncture and moxibustion, and the integration of syndrome differentiation and disease differentiation can effectively treat retention of urine due to neurogenic bladder of patient with diabetes. 展开更多
关键词 Acupuncture and moxibustion Governor vessel urinary retention neurogenic bladder Spinal cord lesions
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The Aging Bladder in Females Evaluated by Urodynamics
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作者 M. C. de Albuquerque Neto Leslie Clifford Noronha Araujo +4 位作者 Thome Decio Pinheiro Barros Junior Joao Luiz Amaro Flavia Cristina Morone Pinto Fabio de Oliveira Vilar Salvador Vilar Correia Lima 《Open Journal of Urology》 2017年第3期54-64,共11页
Aim: To determine whether bladder functions deteriorate with age. Methods: Data contained in electronic medical record (INFOMED?) were used in this institutional retrospective review. Analysis was done on the urodynam... Aim: To determine whether bladder functions deteriorate with age. Methods: Data contained in electronic medical record (INFOMED?) were used in this institutional retrospective review. Analysis was done on the urodynamic studies in women over 18 years old conducted between May 2011 and November 2015. Patients with previous history of pelvic surgery or radiotherapy, neurological disease, vaginal prolapse greater than grade I, congenital urogenital malformations, urinary obstructive disease, diabetes, or the use of any medication that could interfere with bladder function were excluded from the analysis. The urodynamic parameters analyzed were the Maximum Cystometric Capacity (MCC), Voiding Volume (VV), Maximum Flow (Qmax), Bladder Compliance (BC), Detrusor Pressure at Maximum Flow (PdetQmax), Bladder Contractility Index (BCI), Bladder Voiding Efficiency (BVE) and Post-Void Residual Urine Volume (PVR). Patients were further stratified in five groups according to age (A—18 to 40;B—41 to 50;C—51 to 60;D—61 to 70;E—over 70 years old). Results: Out of 3103 urodynamic studies analyzed, 719 were eligible for the study. The average age of patients was 49.3 (+13.2) years old and in all evaluated parameters, statistically significant correlation between age and decline of bladder function was obtained (p Conclusions: This study showed a decline in bladder storage function (reduction in MCC and BC) and in bladder emptying function (reduction in Qmax, PdetQmax, VV, BCI and BVE with an increase in PVR) with age. 展开更多
关键词 AGING urinary bladder Diseases urinary bladder neurogenic OVERACTIVE URODYNAMICS
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Efficacy and safety of onabotulinum toxin A for overactive bladder
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作者 Chintan K Patel Arthur P Mourtzinos 《World Journal of Clinical Urology》 2016年第2期75-79,共5页
Overactive bladder(OAB) syndrome is a condition which affects 16.9% of women and 16.2% of men with a significant negative impact on quality of life. It is a condition characterized by urgency, with or without urge inc... Overactive bladder(OAB) syndrome is a condition which affects 16.9% of women and 16.2% of men with a significant negative impact on quality of life. It is a condition characterized by urgency, with or without urge incontinence, frequency and nocturia. Behavioral modifications and oral anti-muscurinic medications are first and second-line therapies for OAB but are frequently ineffective or poorly tolerated. For refractory cases of OAB, onabotulinum toxin can be offered and this therapy was approved by the Food and Drug Administration in January of 2013. In this editorial, we will review the indications, usage, efficacy and safety data for intradetrusor injection of onabotulinum toxin A. 展开更多
关键词 Onabotulinum toxin A BOTOX OVERACTIVE bladder OVERACTIVE bladder neurogenic bladder urinary bladder DETRUSOR OVERACTIVITY
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补肾通腑方治疗脊髓损伤后神经源性膀胱患者临床疗效
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作者 黄平香 毛平安 方彩莲 《中国药物与临床》 CAS 2024年第12期765-768,共4页
目的探讨补肾通腑方对脊髓损伤后神经源性膀胱(NB)患者临床疗效。方法选择浙江省丽水市人民医院2021年8月至2023年8月脊髓损伤后NB患者94例,按治疗方法分为治疗组(47例)与对照组(47例)。对照组采用膀胱功能训练与间歇性无菌导尿治疗,治... 目的探讨补肾通腑方对脊髓损伤后神经源性膀胱(NB)患者临床疗效。方法选择浙江省丽水市人民医院2021年8月至2023年8月脊髓损伤后NB患者94例,按治疗方法分为治疗组(47例)与对照组(47例)。对照组采用膀胱功能训练与间歇性无菌导尿治疗,治疗组在对照组基础上结合补肾通腑方治疗。2组治疗疗程4周。比较2组治疗疗效、治疗前后中医证候积分、膀胱容量和残余尿量、日平均单次尿量和日平均排尿次数及生活质量变化。结果治疗组总有效率高于对照组(P<0.05)。2组治疗后气短自汗、面色白、倦怠无力和小便频多积分低于治疗前(P<0.05);治疗组治疗后气短自汗、面色白、倦怠无力和小便频多积分低于对照组(P<0.05)。2组治疗后膀胱容量高于治疗前,而残余尿量低于治疗前(P<0.05);治疗组治疗后膀胱容量高于对照组,而残余尿量低于对照组(P<0.05)。2组治疗后日平均单次尿量高于治疗前,而日平均排尿次数低于治疗前(P<0.05);治疗组治疗后日平均单次尿量高于对照组,而日平均排尿次数低于对照组(P<0.05)。2组治疗后泌尿症状困扰评分(USDS)低于治疗前(P<0.05);治疗组治疗后USDS评分低于对照组(P<0.05)。结论补肾通腑方对脊髓损伤后NB患者疗效显著,且可改善患者尿动力学,提高患者生活质量。 展开更多
关键词 补肾通腑方 脊髓损伤 膀胱 神经原性 治疗结果
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“通督益肾”法温针灸联合功能磁刺激治疗脑卒中后尿潴留的临床研究 被引量:1
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作者 樊雨楠 何梦娇 +2 位作者 高山钥 贾静 李艳红 《中国康复》 2024年第1期12-16,共5页
目的:基于“通督益肾”法探讨温针灸联合功能磁刺激治疗卒中后尿潴留的临床疗效。方法:将70例卒中后尿潴留患者随机分为对照组和观察组,每组各35例。其中对照组给予常规针刺和功能磁刺激,观察组在对照组的基础上另对百会、肾俞(双)、命... 目的:基于“通督益肾”法探讨温针灸联合功能磁刺激治疗卒中后尿潴留的临床疗效。方法:将70例卒中后尿潴留患者随机分为对照组和观察组,每组各35例。其中对照组给予常规针刺和功能磁刺激,观察组在对照组的基础上另对百会、肾俞(双)、命门(双)、膀胱俞(双)、太溪(双)进行温针灸,2组治疗各30min,均每日1次,共治疗4周。观察2组治疗前后的膀胱尿动力学、排尿情况、导尿次数等指标差异及治疗后的临床疗效。结果:治疗后,2组的最大膀胱容量、最大尿流率、排尿次数、排尿量均较治疗前增加(P<0.05),充盈期逼尿肌压力、膀胱残余尿量及导尿次数均较治疗前减少(P<0.05),且观察组均优于对照组(P<0.05)。治疗后,观察组总有效率高于对照组(97.1%,77.1%,P<0.05);结论:“通督益肾”法温针灸优于单纯针刺,且联合功能磁刺激显著提高了卒中后尿潴留的临床疗效,可以改善患者临床症状,促进神经功能恢复,提高患者的预后。 展开更多
关键词 脑卒中 温针灸 功能磁 尿潴留 神经源性膀胱 尿动力学
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电针调节P2X7R介导的细胞焦亡途径对骶上脊髓损伤后尿潴留型神经源性膀胱大鼠膀胱排尿功能的影响
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作者 向晶 卓越 +5 位作者 艾坤 邓石峰 许明 刘琼 熊明月 张泓 《湖南中医药大学学报》 CAS 2024年第8期1391-1400,共10页
目的观察电针对骶上脊髓损伤后尿潴留型神经源性膀胱大鼠排尿功能的影响,并探讨电针调节嘌呤能离子通道型受体7(purinergic ligand-gated ion channel 7 receptor,P2X7R)介导的细胞焦亡途径在其中的潜在效应机制。方法从48只雌性SD大鼠... 目的观察电针对骶上脊髓损伤后尿潴留型神经源性膀胱大鼠排尿功能的影响,并探讨电针调节嘌呤能离子通道型受体7(purinergic ligand-gated ion channel 7 receptor,P2X7R)介导的细胞焦亡途径在其中的潜在效应机制。方法从48只雌性SD大鼠中随机抽取12只纳入假手术组,剩余大鼠以T8完全性脊髓横断法建立尿潴留型神经源性膀胱大鼠模型,将已成模的27只大鼠二次随机分为模型组与电针组,每组12只,剩余3只模型大鼠用于实验候补。电针组于术后第19天开始干预,连续10 d,其余两组仅予以捆绑。干预结束后,各组大鼠先行尿流动力学检测,随后快速分离膀胱组织待检,应用HE染色观察膀胱组织形态学变化,透射电镜观察膀胱组织超微结构变化,TUNEL染色检测膀胱组织中细胞损伤情况,ELISA检测膀胱组织中三磷酸腺苷(adenosine triphosphate,ATP)水平,免疫组织化学法和Western blot法检测膀胱组织中P2X7R、NOD样受体热蛋白结构域相关蛋白3(NODlike receptor thermal protein domain associated protein 3,NLRP3)、半胱氨酸天冬氨酸蛋白酶-1(cysteinyl aspartate specific proteinase-1,Caspase-1)、白细胞介素-1β(interleukin-1β,IL-1β)蛋白表达情况。结果与假手术组比较,模型组大鼠膀胱漏尿点压力、膀胱最大压力、膀胱最大容量显著升高(P<0.01),以膀胱体积增大伴尿潴留为主要表现;模型组大鼠膀胱组织存在明显的炎性反应且病理改变显著,膀胱组织超微结构可见明显肿胀、变形等细胞损伤,膀胱组织细胞损伤率显著增加(P<0.01),膀胱组织中ATP含量、P2X7R、NLRP3、Caspase-1、IL-1β的阳性表达及蛋白表达水平均显著升高(P<0.01)。与模型组比较,电针组大鼠膀胱漏尿点压力、膀胱最大压力、膀胱最大容量降低(P<0.05),尿潴留症状较轻,膀胱排尿功能改善;电针组大鼠膀胱组织的炎性反应及病理损伤减轻,膀胱组织超微结构变化明显改善,膀胱组织细胞损伤率显著减少(P<0.01),膀胱组织中ATP含量、P2X7R、NLRP3、Caspase-1、IL-1β的阳性表达及蛋白表达水平均显著降低(P<0.01)。结论电针可有效改善骶上脊髓损伤后尿潴留型神经源性膀胱大鼠的膀胱排尿功能,缓解尿潴留症状,减轻膀胱组织病理损伤程度及其炎症反应,其机制与抑制膀胱组织中P2X7R/NLRP3信号通路焦亡蛋白的表达有关。 展开更多
关键词 骶上脊髓损伤 神经源性膀胱 尿潴留 电针 嘌呤能离子通道型受体7 细胞焦亡
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骶神经调控术对神经源性膀胱疗效的Meta分析
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作者 苏宇航 亓文强 史本康 《现代泌尿外科杂志》 CAS 2024年第4期353-358,362,共7页
目的采用Meta分析评价骶神经调控术(SNM)对神经源性膀胱(NB)的疗效,为临床提供关于NB治疗选择的参考。方法通过检索PubMed及知网数据库,收集国内外2010年1月—2022年12月有关SNM治疗NB的文献,按照纳入排除标准筛选文献,并进行质量评价,... 目的采用Meta分析评价骶神经调控术(SNM)对神经源性膀胱(NB)的疗效,为临床提供关于NB治疗选择的参考。方法通过检索PubMed及知网数据库,收集国内外2010年1月—2022年12月有关SNM治疗NB的文献,按照纳入排除标准筛选文献,并进行质量评价,提炼数据后采用Review Manager 5.3统计软件进行分析。结果共纳入14项研究、601例患者。Meta分析结果示:SNM对NB患者的排尿次数(WMD=4.30,95%CI:2.84~5.77,P<0.01)、每日尿失禁发作次数(WMD=2.92,95%CI:2.76~3.07,P<0.01)、单次排尿量(WMD=-113.93,95%CI:-159.91~-67.98,P<0.01)、最大尿流率(WMD=-3.23,95%CI:-4.04~-2.42,P<0.01)、残余尿(WMD=111.79,95%CI:79.93~143.64,P<0.01)、最大膀胱容量(WMD=-65.63,95%CI:-84.38~-46.88,P<0.01)以及膀胱顺应性(WMD=-4.65,95%CI:-8.75~-0.55,P=0.03)有显著改善。结论SNM治疗NB的有效性较好,但需要更多随机对照试验的支持。 展开更多
关键词 骶神经调控术 神经源性膀胱 下尿路功能障碍 下尿路症状 排尿次数 每日尿失禁发作次数 单次排尿量 最大尿流率 残余尿 最大膀胱容量 膀胱顺应性
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脊髓损伤后神经源性膀胱患者容量管理最佳证据总结 被引量:1
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作者 徐晨阳 周红 +5 位作者 孟玲 耿敬 徐海艳 吕英瑛 崔立新 周娟 《护理学杂志》 CSCD 北大核心 2024年第8期64-69,共6页
目的全面检索并总结脊髓损伤后神经源性膀胱患者容量管理的最佳证据。方法依据证据金字塔模型,系统检索国内外数据库及官方网站,检索时限为建库至2023年11月10日,进行文献质量评价后,对证据进行提取和整合。结果最终纳入20篇文献,形成... 目的全面检索并总结脊髓损伤后神经源性膀胱患者容量管理的最佳证据。方法依据证据金字塔模型,系统检索国内外数据库及官方网站,检索时限为建库至2023年11月10日,进行文献质量评价后,对证据进行提取和整合。结果最终纳入20篇文献,形成评估、排尿管理、饮食护理、药物护理、康复护理、观察指标、健康教育7个方面20条证据。结论形成的脊髓损伤后神经源性膀胱患者容量管理最佳证据可以为护理实践提供循证依据。 展开更多
关键词 脊髓损伤 神经源性膀胱 尿潴留 容量管理 排尿管理 证据总结 康复护理 循证护理
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基于尿流动力学和膀胱安全容量的脊髓损伤后神经源性膀胱个体化综合尿控管理效果观察 被引量:1
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作者 苏曼珊 刘静 +1 位作者 吴淑卿 赵小红 《中国当代医药》 CAS 2024年第12期175-179,共5页
目的探讨基于尿流动力学和膀胱安全容量的个体化综合尿控管理在脊髓损伤后神经源性膀胱患者中的应用效果。方法选取2021年7月至2023年7月广东省工伤康复医院收治的60例脊髓损伤后神经源性膀胱患者作为研究对象,采用随机数字表法分为观... 目的探讨基于尿流动力学和膀胱安全容量的个体化综合尿控管理在脊髓损伤后神经源性膀胱患者中的应用效果。方法选取2021年7月至2023年7月广东省工伤康复医院收治的60例脊髓损伤后神经源性膀胱患者作为研究对象,采用随机数字表法分为观察组和对照组,每组30例。对照组采取基于尿流动力学的尿控管理,观察组在对照组基础上采取以膀胱容量扫描仪为指导的个体化综合尿控管理,两组均持续干预观察4周。比较两组患者神经源性膀胱症状变化、不良事件发生情况、尿路感染情况以及生活质量。结果观察组干预后神经源性膀胱症状评分均低于对照组,差异有统计学意义(P<0.05);观察组不良事件总发生率、尿路感染发生率均低于对照组,差异有统计学意义(P<0.05);观察组干预后健康调查简表(SF-36)各项评分均高于对照组,差异有统计学意义(P<0.05)。结论基于尿流动力学和膀胱安全容量的个体化尿控管理方案可改善脊髓损伤后神经源性膀胱患者神经源性膀胱症状,降低不良事件及尿路感染的发生率,促进患者生活质量提升。 展开更多
关键词 脊髓损伤 神经源性膀胱 膀胱安全容量 个体化综合尿控管理
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伴上尿路扩张的尿崩症患者的诊断和治疗:一项单中心临床研究
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作者 王学胜 周忠涵 +2 位作者 李兴 李勋华 廖利民 《现代泌尿外科杂志》 2024年第1期12-17,64,共7页
目的通过影像尿动力学检查(VUDS)和全尿路功能障碍(AUTD)分级系统描述伴上尿路扩张(UUTD)的尿崩症(DI)患者的全尿路特征,归纳总结伴UUTD的DI患者的诊断和治疗经验。方法回顾性分析中国康复研究中心于2010年1月—2020年1月收治的28例伴U... 目的通过影像尿动力学检查(VUDS)和全尿路功能障碍(AUTD)分级系统描述伴上尿路扩张(UUTD)的尿崩症(DI)患者的全尿路特征,归纳总结伴UUTD的DI患者的诊断和治疗经验。方法回顾性分析中国康复研究中心于2010年1月—2020年1月收治的28例伴UUTD的DI患者的临床资料,采用UUTD和AUTD分级系统评估患者的上尿路特征。总结分析所有患者的实验室检查、VUDS、UUTD、神经电生理检查、治疗方案和随访结果等临床资料。结果28例伴UUTD患者中DI患者21例(75.0%),DI合并神经源性膀胱(NB)患者7例(25.0%)。除2例DI合并NB患者因膀胱容量小、顺应性差以及肾功能不全行肠道膀胱扩大成形术外,其余26例(92.9%)患者通过药物治疗联合膀胱颈切开等个体化治疗以及相应的膀胱管理(包括间歇性导尿、留置尿管和规律排尿)取得了满意的治疗效果。13例(46.4%)肾功能异常患者的血肌酐水平从(269.8±105.7)μmol/L下降到(164.4±90.2)μmol/L。28例患者的48条扩张输尿管的上尿路积水扩张分级明显改善,患者的上尿路积水扩张分级中位数由3级降至2级。结论膀胱容量增加、膀胱小梁形成和感觉减退或消失是伴有UUTD的DI患者的共同特征,个体化药物治疗结合合理的膀胱管理可改善DI患者的上尿路扩张程度和肾功能。 展开更多
关键词 尿崩症 膀胱扩张 上尿路扩张 神经源性膀胱 个体化治疗 诊断流程
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神经源性下尿路功能障碍中尿源性生物标志物的研究进展
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作者 孙朋浩 宋伟 《泌尿外科杂志(电子版)》 2024年第1期54-58,共5页
神经源性下尿路功能障碍(neurogenic lower urinary tract dysfunction,NLUTD)是一类由神经系统病变导致膀胱和(或)尿道功能障碍产生的一系列并发症的疾病总称。目前,对于该疾病的诊断与监测主要基于侵入性尿流动力学检查。有研究发现,... 神经源性下尿路功能障碍(neurogenic lower urinary tract dysfunction,NLUTD)是一类由神经系统病变导致膀胱和(或)尿道功能障碍产生的一系列并发症的疾病总称。目前,对于该疾病的诊断与监测主要基于侵入性尿流动力学检查。有研究发现,一些尿源性生物标志物在NLUTD患者的尿液中升高,例如神经生长因子、前列腺素、炎性细胞因子、中性粒细胞明胶酶相关脂质运载蛋白、参与细胞外基质降解的蛋白质等。这些尿源性生物标志物作为一种非侵入性的监测方法或许可以为该疾病的诊断与监测带来突破,并进一步成为尿动力学检查的一种微创替代方法。基于此,本文总结了多种用于NLUTD及其并发症诊断与监测的尿液生物标志物,并分析目前的研究进展。 展开更多
关键词 神经源性下尿路功能障碍 神经源性膀胱 尿液分析 生物标志物
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夹脊电场疗法治疗骶上脊髓损伤后神经源性膀胱尿失禁临床观察
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作者 宗凯 平启年 +1 位作者 史进 刘刚 《光明中医》 2024年第18期3729-3732,共4页
目的 探讨夹脊电场疗法治疗骶上脊髓损伤后神经源性膀胱尿失禁的有效性。方法 将2019年10月—2022年10月就诊于兴化市中医医院的骶上脊髓后神经源性膀胱尿失禁患者60例,按就诊顺序随机分为治疗组和对照组,每组30例。治疗组采用骶上脊髓... 目的 探讨夹脊电场疗法治疗骶上脊髓损伤后神经源性膀胱尿失禁的有效性。方法 将2019年10月—2022年10月就诊于兴化市中医医院的骶上脊髓后神经源性膀胱尿失禁患者60例,按就诊顺序随机分为治疗组和对照组,每组30例。治疗组采用骶上脊髓损伤部位上下节段夹脊电针密波联合肾俞、会阳电针疏波治疗;对照组采用膀胱功能训练法治疗。治疗2个疗程后,观察并比较2组治疗效果。结果 治疗后,2组患者残余尿量、漏尿次数、1 h尿垫试验漏尿量、SQLP评分均改善(P<0.05),治疗组优于对照组(P<0.05);治疗组总有效率高于对照组,差异具有统计学意义(P<0.05)。结论 夹脊电场疗法能显著改善骶上脊髓损伤后神经源性膀胱尿失禁患者临床症状,减少残余尿量、漏尿次数、1 h尿垫试验的漏尿量、降低SQLP量表评分,其疗效优于膀胱功能训练法治疗。 展开更多
关键词 遗溺 神经源性膀胱 尿失禁 夹脊电场疗法
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早期康复护理干预对脊髓损伤神经源性膀胱患者尿路感染和膀胱功能的影响研究
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作者 陈建洪 李维佳 《科技与健康》 2024年第19期75-78,共4页
探究早期康复护理干预对脊髓损伤(spinal cord injury,SCI)神经源性膀胱患者尿路感染和膀胱功能的影响。选取云南省第一人民医院2023年6月-2023年12月收治的80例SCI神经源性膀胱患者为研究对象。采用随机数字表法将患者分为两组,分别为... 探究早期康复护理干预对脊髓损伤(spinal cord injury,SCI)神经源性膀胱患者尿路感染和膀胱功能的影响。选取云南省第一人民医院2023年6月-2023年12月收治的80例SCI神经源性膀胱患者为研究对象。采用随机数字表法将患者分为两组,分别为对照组和观察组,每组各40例。对照组实施常规护理,观察组在对照组的基础上实施早期康复护理干预,比较两组患者的护理效果。结果显示,观察组膀胱功能明显优于对照组,组间数据差异具有统计学意义(P<0.05);观察组尿路感染发生率低于对照组,组间数据差异具有统计学意义(P<0.05)。研究发现,早期康复护理干预可有效改善患者的膀胱功能,降低尿路感染发生率,具有较高的临床应用价值。 展开更多
关键词 早期康复护理 脊髓损伤 神经源性膀胱 尿路感染 膀胱功能
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艾灸联合电刺激治疗神经源性膀胱的疗效观察
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作者 陈吉翠 朱希成 +3 位作者 汪为聪 鲍芳 袁翠红 丁曾霞 《上海针灸杂志》 CSCD 2024年第11期1234-1238,共5页
目的观察艾灸联合电刺激治疗神经源性膀胱的临床疗效。方法将90例神经源性膀胱且留置导尿患者随机分为对照组和观察组,每组45例。两组均接受常规基础治疗,对照组予以电刺激治疗,观察组在对照组基础上采用艾灸治疗。观察两组治疗前后残... 目的观察艾灸联合电刺激治疗神经源性膀胱的临床疗效。方法将90例神经源性膀胱且留置导尿患者随机分为对照组和观察组,每组45例。两组均接受常规基础治疗,对照组予以电刺激治疗,观察组在对照组基础上采用艾灸治疗。观察两组治疗前后残余尿量、膀胱功能评分、日常生活活动能力(activity of daily living,ADL)评分和肛门括约肌舒缩波幅的变化,并比较两组临床疗效。结果观察组总有效率为88.9%,对照组为71.1%,两组比较差异有统计学意义(P<0.05)。治疗后,两组残余尿量均下降(P<0.05),且观察组低于对照组(P<0.05)。治疗后,两组肛门括约肌扩张波幅、收缩波幅均上升(P<0.05),且观察组高于对照组(P<0.05)。治疗后,两组膀胱功能评分下降(P<0.05),ADL评分上升(P<0.05),且观察组优于对照组(P<0.05)。结论在常规基础治疗的基础上,艾灸联合电刺激可提高神经源性膀胱患者治疗效果,改善其残余尿量、肛门括约肌舒缩波幅和膀胱功能评分,提高生活质量。 展开更多
关键词 灸法 隔姜灸 电刺激疗法 膀胱 神经源性 尿动力学 膀胱功能
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