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  

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

作　　者：廖利民[1] 邱志勇[1] 韩春生[1] 熊宗胜[1] 鞠彦合[1] 李东[1] 史文博[1] 吴娟[1] 黄悦[1] 

机构地区：[1]北京博爱医院泌尿外科,北京市100068

出　　处：《中国康复理论与实践》2005年第11期899-900,共2页Chinese Journal of Rehabilitation Theory and Practice

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.Objective To explore the effects of sacral neuromodulation using a new tined-lead electrode on neurogenic bladder. Methods The 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 $3 foramen under the X-ray screening. Subjects completed the record- ing 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. Results Urinary fre- quency 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. Conclusion A new tined-lead electrode for sacral neuromodulation provide a new alterative and minimally invasive procedure to treat neurogenic bladder.

关 键 词：骶神经调节 神经源性膀胱 倒刺电极 尿动力学 

分 类 号：R694[医药卫生—泌尿科学]