膀胱颈悬吊术在儿童神经源性尿失禁治疗的研究现状  

Clinical application of bladder neck suspension in treatment of children with neurogenic urinary incontinence

作　　者：王佳璇 黄立渠 郭云飞[1] Wang Jiaxuan;Huang Liqu;Guo Yunfei(Department of Urology,Children′s Hospital of Nanjing Medical University,Nanjing 210008,Jiangsu Province,China)

机构地区：[1]南京医科大学附属儿童医院泌尿外科,南京210008

出　　处：《中华妇幼临床医学杂志（电子版）》2024年第2期179-184,共6页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：国家自然科学基金项目(82000643);江苏省自然科学基金青年项目(BK20200152)。

摘　　要：儿童尿失禁对儿童的生活质量和心理健康产生不良影响。采取行为疗法和生活方式干预、药物治疗等传统治疗方法,对轻度至中度尿失禁的儿童有效,但对于脊髓发育不良所致神经源性尿失禁(NUI)患儿,可能需要考虑手术治疗。NUI患儿常合并膀胱出口阻力低、盆底肌瘫痪和尿道括约肌功能不全等问题。膀胱颈悬吊术(BNS)是将膀胱颈和后尿道悬吊于耻骨后的手术操作,可以加强盆底对膀胱颈和后尿道支撑,降低腹压增大时膀胱颈下移程度,从而可降低尿失禁发生率。因此,BNS为针对儿童NUI的一种手术治疗选择,旨在加强膀胱颈部位的支持,以减轻尿失禁症状。笔者拟就儿童NUI的研究背景与BNS历史发展和应用范围及其基本操作方式,BNS在NUI患儿的应用及其局限性,以及BNS与治疗NUI患儿的其他术式比较的最新研究现状进行阐述。Pediatric urinary incontinence can have adverse effects on a child′s quality of life and mental health.Traditional treatments,including behavioral therapy and lifestyle interventions,medications,are effective for children with mild to moderate urinary incontinence,but for those with neurogenic urinary incontinence(NUI)due to spinal cord dysplasia,more invasive treatments may need to be considered.Bladder neck suspension(BNS)is a surgical procedure in which the bladder neck and posterior urethra are suspended to the posterior aspect of the pubic bone.It can strengthen pelvic floor support for the bladder neck and posterior urethra,reduce the degree of descent of the bladder neck during increases in intra-abdominal pressure,and thereby lowers the incidence of urinary incontinence.Therefore,BNS is a surgical treatment option for children with NUI designed to strengthen support at the neck position of the bladder to reduce symptoms of urinary incontinence.The authors intend to elaborate on the latest researches of background of pediatric NUI,the historical development and application scope and basic operative techniques of BNS,the application of BNS in children with NUI and its limitations,and comparison of BNS with other surgical techniques for children with NUI.

关 键 词：尿失禁 神经源性尿失禁 神经管缺损 尿道括约肌功能不全 盆底疾病 膀胱颈悬吊术 儿童 

分 类 号：R726.9[医药卫生—儿科]