索利那新联合生物反馈治疗儿童神经源性膀胱过度活动症的疗效分析  

Analysis of the efficacy of solifenacin combined with biofeedback in the treatment of neuro-genic overactive bladder in children

作　　者：刘丹 张辉 LIU Dan;ZHANG Hui(Department of Pediatrics,West China Second University Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西第二医院儿科,四川成都610041

出　　处：《实用医院临床杂志》2025年第2期18-21,共4页Practical Journal of Clinical Medicine

基　　金：四川省医学会科研基金资助项目(编号:S16052)。

摘　　要：目的探讨索利那新联合生物反馈治疗儿童神经源性膀胱过度活动症的有效性和安全性。方法纳入神经源性膀胱过度活动症患儿20例,分为两组:A组10例患儿接受索利那新治疗,B组10例患儿接受索利那新联合生物反馈治疗。对比两组患儿在治疗开始后第4、8、12和24周的完全缓解率、平均导尿量、尿动力学参数及膀胱输尿管反流(VUR)级别。结果初次治疗8周时,两组完全缓解率分别为10.0%(1/10)和20.0%(2/10)。12周时,两组完全缓解率分别为10.0%(1/10)和40.0%(4/10),B组总缓解率高于A组(P<0.05);B组平均导尿量也较治疗前明显增加(P<0.05)。24周时,两组的完全缓解率分别为20.0%(2/10)和60.0%(6/10),B组的完结缓解率、总缓解率、平均导尿量高于A组(P<0.05);B组患儿的膀胱顺应性、逼尿肌不稳定性等尿动力学参数、VUR反流级别的改善优于A组(P<0.05)。随访期间1例患儿出现便秘,通过减少索利那新的剂量,患儿便秘明显缓解。结论索利那新联合生物反馈是一种有效且耐受性良好的治疗儿童神经源性膀胱过度活动症的有效方案,值得在临床上广泛采用。Objective To investigate the efficacy and safety of solifenacin combined with biofeedback in the treatment of pediatric neurogenic detrusor overactive(NDO).Methods Twenty children with NDO were involved.The sick children divided into group A and group B.The group A(n=10)was treated with solifenacin.The group B(n=10)was treated with solifenacin combined with biofeedback.The complete response rates,median catheterized volumes,urodynamic parameters and the degrees of vesicouretral reflux(VUR)were compared between the two groups after 4,8,12 and 24 weeks of the beginning of treatment.Results After 8 weeks of initial treatment,the complete remission rates of the two groups were 10.0%(1/10)and 20.0%(2/10),respectively.The complete remission rate of the group B was higher than that of the group A(P<0.05).At the 12th weeks after treatment,the complete remission rates in the two groups were 20.0%(2/10)and 40.0%(4/10),respectively.The average urinary catheterization volume of the group B was also increased significantly compared with that before treatment(P<0.05).At the 24th weeks after treatment,the complete remission rates of the two groups were 40.0%(4/10)and 60.0%(6/10),respectively.The improvement of urodynamic parameters such as bladder compliance,detrusor instability and VUR level of children in the group B was better than that of the group A(P<0.05).During the follow-up period,one child developed constipation.By reducing the dose of solifenacin,the child's constipation was significantly relieved.Conclusions Solifenacin combined with biofeedback are effective and well tolerated as an available regimen for children with NDO.It is wworthy of widespread clinical adoption.

关 键 词：神经源性逼尿肌过度活动 索利那新 生物反馈 疗效 儿童 

分 类 号：R694.5[医药卫生—泌尿科学]