儿童脑性瘫痪尿流动力学特征及其临床意义

目的：探讨儿童脑性瘫痪尿流动力学特征及其临床意义。材料和方法：本组病例为采用选择性脊神经后根切断术的脑瘫儿童78例，术前1周内行尿流动力学检查。结果：25例（32．05％）脑瘫儿童合并下尿路症状，尿流动力学检查其中20例为上运动神经元损害、3例为混合型运动神经元损害、1例为单纯下运动神经元损害、1例正常；53例（67．95％）脑瘫儿童无下尿道临床症状，尿流动力学检查中35例（66．04％）膀胱总容量及顺应性下降、膀胱充盈压增加。结论：尿流动力学检查可明确脑瘫儿童下尿道症状的神经病学原因，同时发现无下尿道症状的脑瘫儿童中至少50％以上合并临床静止性膀胱功能障碍，符合SPR适应证的患儿应尽早行SPR术。

Urodynamic StudiesCharacteristics of Patient with Cerebral Palsy and Its Clinical Significance

Objective:To evaluate the urodynamic studies characteristics of children with cerebral palsy and its clinical significance.Methods:We reviewed urodynamic studies in 78 cases of cerebral palsy who underwent selective posterior rhizotomy within one week preoperatively.Result:25 out of 78 (32.05%) children with cerebral palsy presented with lower urinary tract symptoms and of the patients 20 cases had evidence of a pure upper motor neuron injury in urodynamic studies,3 cases a mixed motor neuron injury,1 case a pure lower motor neuron injury and 1 case normal;Out of 53 (67.95%) cases without dysfunctional voiding symptoms,35 (66.04%) cases manifested the decrease of total bladder capacity and bladder compliance,as well as the increase of bladder filling pressure.Conclusion:Urodynamic studies are effective methods to identify neuropathic etiology of lower urinary tract symptom in childern with cerebral palsy.According to urodynamic studies,at least half of the children with cerebral palsy,if fit for SPR,who need SPR management as soon as possible,have clinically silent bladder dysfunction.