骶神经调节在难治性膀胱过度活动症治疗中的思考和展望  

Reflections and perspectives on sacral neuromodulation in the treatment of refractory overactive bladder disorder

作　　者：秦川 郝钢跃[1] Qin Chuan;Hao Gangyue(Department of Urology,Beijing Friendship Hospital,Capital Medical University,Beijing 100032,China)

机构地区：[1]首都医科大学附属北京友谊医院泌尿外科,北京100050

出　　处：《国际外科学杂志》2023年第7期442-446,共5页International Journal of Surgery

基　　金：2022年北京友谊医院"友谊种子计划"项目(YYZZ202234)。

摘　　要：膀胱过度活动症(OAB)是泌尿外科常见疾病, OAB的一线治疗方案包括行为疗法以及M受体阻滞剂和β3肾上腺素受体激动剂药物治疗。而行为治疗失败, 单用M受体拮抗剂等药物治疗6~12周后疗效未达预期或无法耐受口服药物不良反应的OAB患者称为难治性OAB。难治性OAB患者可进行手术干预, 如骶神经调节(SNM)、膀胱壁内注射A型肉毒素及经皮胫神经刺激中获益。和其他手术相比, SNM疗效显著, 且不良反应发生率较低。笔者思考未来可以针对肠道菌群-尿液菌群-代谢组学以及尿控相关大脑结构-脊髓功能结构-盆底周围神经结构的整体变化来开展SNM治疗难治性OAB的研究。Overactive bladder(OAB)is a common urological condition.First-line treatment for OAB includes behavioral therapy as well as pharmacological treatment with M-blockers andβ3-adrenoceptor agonists.Patients with OAB who fail behavioral therapy and do not achieve the desired outcome after 6-12 weeks of treatment with M receptor antagonists alone or who cannot tolerate the adverse effects of oral medications are referred to as refractory OAB.patients with refractory OAB can be treated with surgical interventions such as Sacral Neuromodulation(SNM),intravesical Botulinum Toxin type A.BTX-A and Percutaneous Tibial Nerve Stimulation.Compared with other procedures,SNM is highly effective and has a low incidence of adverse effects.The author contemplates that future studies of SNM for refractory OAB could be conducted to address the overall changes in intestinal flora-urinary flora-metabolomics and urinary control-related brain structure-spinal cord functional structure-peripheral pelvic floor nerve structure.

关 键 词：膀胱 膀胱疾病 过度活动性 难治性膀胱过度活动症 骶神经调节 

分 类 号：R699[医药卫生—泌尿科学]