《中国康复理论与实践》

《中国康复理论与实践》 ›› 2001, Vol. 7 ›› Issue (02): 64-65.

• 专题研究 • 上一篇    下一篇

46例脊髓损伤患者并发肾积水的疗效分析

刘根林; 汪家琮; 周红俊; 郑樱; 熊宗胜; 张贵平   

  1. 北京博爱医院 北京市 100077
  • 收稿日期:2000-02-25 出版日期:2001-06-25 发布日期:2001-06-25

Retrospective analysis of effect of treatment on hydronephrosis in 46 spinal cord injured patients

LIU Gen-lin,WANG Jia-zong,ZHOU Hong-jun,et al   

  1. Biejing Bo'ai Hospital affiliated to China Rehabilitation Research Center,Berjing 100077,China
  • Received:2000-02-25 Published:2001-06-25 Online:2001-06-25

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摘要： 目的探讨脊髓损伤并发肾积水的最佳治疗途径。方法46例患者分别采用留置尿管、间歇导尿和药物疗法、综合方法进行治疗,观察肾积水缓解所需的治疗时间和复发情况。结果 3种治疗方法所需的治疗时间无差异;逼尿肌反射亢进合并括约肌痉挛(DSD)的复发率(85.7%)高于逼尿肌反射亢进者(35%)和低下者(25%)。结论建议首选间歇导尿和药物疗法治疗轻、中度肾积水,以避免长期留置尿管的并发症;SCI并发肾积水病程隐匿且易复发,早期B超检查有助于尽早发现肾积水;早期治疗预后较佳;尿流动力学检查结果对SCI肾积水的处理有指导意义。

关键词: 脊髓损伤, 康复, 肾积水, 间歇导尿, B超, 尿流动力学

Abstract: ObjectiveTo search for the optimal treatment of hydronephrosis after spinal cord injury .Methods46 cases were treated by indwelling catheter, intermittent catheterization and drug therapy, and comprehensive therapy respectively. The course of treatment and the recurrence rate were observed after hydronephrosis remitted. Results There were no differences in the course of treatment among the three different kinds of therapy. The recurrence rate of the detrusor sphincter dyssynergia(85.7%) was higher than that of the detrusor hyperreflexia (35%) and the detrusor hyporeflexia(25%).ConclusionsThe optimal therapy on slight and moderate hydronephrosis should be intermittent catheterization and drug therapy to avoid the complications of long term indwelling catheter. SCI hydronephrosis is indistinct and recurrent easily. B ultrasound for kidneys is helpful in discovering SCI hydronephrosis on early stage. The earlier the treatment, the better the prognosis. Urodynamics plays an important role in the management of SCI hydronephrosis.

Key words: spinal cord injury, rehabilitation, hydronephrosis, intermittent catheterization, B ultrasound, urodynamics