《中国康复理论与实践》

《中国康复理论与实践》 ›› 2005, Vol. 11 ›› Issue (11): 899-900.

• 专题 • 上一篇    下一篇

使用新型倒刺电极的骶神经调节治疗神经源性膀胱的初步临床结果

廖利民; 邱志勇; 韩春生; 熊宗胜; 鞠彦合; 李东; 史文博; 吴娟; 黄悦   

  1. 北京博爱医院泌尿外科 北京市 100068
  • 收稿日期:2005-10-08 出版日期:2005-11-25 发布日期:2005-11-25

Preliminary clinical report of treatment for neurogenic bladder by sacral neuromodulation using a new tined-lead electrode

LIAO Li-min, QIU Zhi-yong, HAN Chun-sheng, et al   

  1. Department of Urology, Beijing Charity Hospital,Beijing 100068, China
  • Received:2005-10-08 Published:2005-11-25 Online:2005-11-25

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被引次数

25

摘要： 目的探讨应用新型倒刺电极(Tined-lead)对神经源性膀胱患者行S3骶神经调节(SNM)的初步疗效。方法对5例神经源性膀胱患者采用新型倒刺电极,在X线监测下将电极植入S3骶神经孔,进行SNM。术前、术后详细记录排尿日记,用影像尿动力学方法评估患者的膀胱尿道功能。结果患者1(隐性骶裂)术后排尿次数和排尿量分别改善22%和49%;患者2(隐性骶裂)术后排尿次数、排尿量和残余尿量分别改善0.7%、11%和46%;患者3(隐性骶裂)术后排尿次数、排尿量和残余尿量分别改善0.4%、18%和44%。患者4(脑外伤)术后漏尿次数和漏尿量分别改善36%和54%。患者5(高位截瘫)术后间歇导尿次数和导尿量分别改善42%和54%,尿动力学参数改善37%～45%。结论用新型倒刺电极进行SNM为神经源性膀胱的治疗提供了一条新的可供选择的微创方法。

关键词: 骶神经调节, 神经源性膀胱, 倒刺电极

Abstract: ObjectiveTo explore the effects of sacral neuromodulation using a new tined-lead electrode on neurogenic bladder.MethodsThe use of a new tined-lead electrode for sacral neuromodulation was evaluated in a study including 5 consecutive patients with neurogenic bladder.The tined leads were implanted at the S3 foramen under the X-ray screening.Subjects completed the recording of detailed voiding diary pre-and post-operation including fluid intake,voided volume,leaked volume,catheterized volume,frequency,accompanying symptoms and sensation.Vesicourethral function was assessed by video-urodynamics.ResultsUrinary frequency and voided volume were improved 22% and 49% respectively in one patient with spinal bifida.Urinary frequency,voided volume and residual volume were improved 0.7%,11% and 46% respectively in another one.Urinary frequency,voided volume and residual volume were improved 0.4%,18% and 44% respectively in the third one.Frequency of leakage and leaked volume were improved 36% and 54% respectively in the patient with brain trauma.Frequency of CIC and catheterized volume were improved 42% and 54% respectively,and indexes of urodynamics were improved 37%～45% in the patient with spinal cord injury.ConclusionA new tined-lead electrode for sacral neuromodulation provide a new alterative and minimally invasive procedure to treat neurogenic bladder.

Key words: sacral neuromodulation, neurogenic bladder, tined-lead electrode