膀胱腹直肌间置术治疗无反射性神经膀胱

目的：评价膀胱腹直肌间置术治疗神经膀胱的临床效果。方法：通过尿流动力学检查选择无反射膀胱患者５４例,通过手术将膀胱置于腹直肌及其前后鞘之间,手术后２症状、 情况及残余尿量的改变。结果：手术后８１．５％的口才可自行排尿,症 状好转或;手术后残余尿量较手术前有显著性减少。结论：膀胱腹直肌间置术是治疗神经膀胱的有效方法之一,有利于患者的康复。     

膀胱腹直肌间置术治疗神经原性膀胱的疗效观察

采用本院设计的膀胱腹直肌间置术治疗神经原性膀胱39例,效果良好。认为,手术成功的关键是适应证的选择,主要治疗逼尿肌无反射而尿道压正常的患者。术后定期随访十分重要,随诊中应注意残余尿量,有无尿路感染及结石,必要时行尿流动力学检查,发现问题及时处理,以免影响疗效及损害肾功能。     

膀胱次全切除回肠扩大膀胱术治疗神经源性膀胱尿道功能障碍

目的：探讨肠道扩大膀胱成形术治疗神经源性膀胱尿道功能障碍的价值。方法：采用膀胱次全切除、回肠扩大膀胱成形术治疗7例神经源性膀胱尿道功能障碍患者。结果：2例术后排尿通畅，剩余尿消失；3例术后曾有排尿困难，经尿道膀胱颈电切后排尿通畅，无尿失禁，最大尿流率分别为27、16和18ml/s；1例术前曾采用经尿道膀胱颈电切术无效，行本手术后剩余尿消失，但仍有尿失禁，后在超声引导下于尿道周围注射硅酮后，尿失禁症状明显改善；余1例术后仍有排尿困难。结论：该手术方法对神经源性膀胱尿道功能障碍是一种可行的治疗方法。     

腹直肌转位术治疗小儿逼尿肌无反射性神经源性膀胱(附22例报告)

目的 :探讨小儿神经源性膀胱的手术治疗指征及疗效。方法 :对 2 2例小儿神经源性膀胱的患儿 ,经膀胱测压、尿道测压、冰水实验、膀胱造影等检查 ,确定是逼尿肌无反射 ,且不并发输尿管反流 ,尿道压力在正常范围内者行腹直肌转位术。结果 :本组 2 2例患者 ,2 0例尿失禁症状明显好转 ,能自行排尿 ,剩余尿量明显减少 ,2例尿失禁症状无改善。术后 10例测最大尿流率 >15ml/s。 4例术前肾功能中度受损患儿 ,3例术后肾功能明显改善 ,5例术前肾功能轻度受损患儿 ,4例肾功能恢复正常。结论 :此手术对于保护患儿的肾功能及提高生活质量有较好的作用。是治疗小儿逼尿肌无反射性神经源性膀胱的可行手术方法     

康复护理在神经源性膀胱功能重建中的应用

目的探讨康复护理在神经源性膀胱功能重建的应用效果。方法对22例神经源性膀胱功能重建患者给予间歇导尿、自主排尿等康复护理措施,观察护理后患者膀胱容量、残余尿量、并发症情况。结果本组患者均成功拔管,治疗后患者膀胱容量明显大于治疗前,残余尿量明显小于治疗前,比较差异有统计学意义(P0.05)。结论做好康复护理措施能有效促进神经源性膀胱功能重建患者增加膀胱容量,减少残余尿量,并发症发生率低,效果满意。     

乙状结肠肌瓣包膀胱术治疗膀胱逼尿肌收缩无力

为探讨治疗神经原性膀胱逼尿肌收缩无力的方法,按神经原性膀胱诊断指标,选16例病人,并经B超或X线证实。采用带蒂游离非管状乙状结肠肌瓣包裹膀胱,两组织裸面粘合成统一体,协同收缩加强逼尿肌收缩力,使排尿通畅。术后观察,12例排尿顺利,4例改善,随访1年以上9例,残余尿量在100ml以下。表明乙状结肠肌瓣收缩力强,与膀胱同属盆神经支配且两者位置相邻近。本术式加强了逼尿肌功能,残余尿量明显减少,是治疗膀胱逼尿肌收缩无力的简单有效的方法。     

乙状结肠肌瓣包膀胱术治疗膀胱逼尿肌收缩无力

为探讨治疗神经原性膀胱逼尿肌收缩无力的方法，按神经原性膀胱诊断指标，选16例病人，并经B超或X线证实。采用带蒂游离非管状乙状结肠肌瓣包装膀胱，两组织裸面粘合成统一体，协同收缩加强尿肌收缩力，使排尿通畅。术后观察，12例排尿顺利，4例改善，随访1年以上9例，残余尿量在100ml以下。表明乙状结晶肠肌瓣收缩力强，与膀胱同属盆神经支配且两位置相邻近。本术式加强了逼尿肌功能，残余尿量明显减少，是治疗膀胱逼尿肌收缩无力的简单有效的方法。     

乙状结肠肌瓣包膀胱术治疗膀胱逼尿肌收缩无力症

采用自行设计乙状结肠肌瓣包膀胱术治疗膀胱逼尿肌收缩无力10例，8例优良，2例改善，随访1年以上者6例，术后排尿通畅，残余尿量少于100ml。认为乙状结肠有收缩力强、容量大、可完全包裹膀胱的优点。去粘膜乙状结肠肌瓣包膀胱术，加强了膀胱通尿肌收缩力，残余尿量明显减少，能有效保护肾功能，是治疗膀胱逼尿肌收缩无力简单有效的手术方法。     

综合治疗系统性红斑狼疮引起神经源性膀胱导致尿潴留4例分析

目的探讨系统性红斑狼疮引起神经源性膀胱导致尿潴留的综合治疗方法。方法回顾性分析4例系统性红斑狼疮引起神经源性膀胱患者的临床资料。4例患者采取营养神经、膀胱康复训练、针刺治疗和穴位注射的综合治疗措施。结果综合治疗4例系统性红斑狼疮引起神经源性膀胱导致的尿潴留，患者可以自行排尿，形成自律性膀胱，残余尿量减少，取得较好的疗效。结论综合治疗系统性红斑狼疮引起的神经源性膀胱导致的尿潴留，疗效可靠，值得临床推广。     

糖尿病神经源性膀胱患者排尿功能训练效果观察

对７３例糖尿病神经源性膀胱患者进行腹部肌肉收缩和体位前倾锻炼，腹部膀胱区按摩及诱导定时排尿等训练，结果：训练后膀胱残余尿量减少，排尿障碍好转。训练前后比较，经χ＾２检验，Ｐ〈０．００５，具有极显著性差异。提示加强排尿功能的训练，能有效地促进糖尿病神经源性膀胱功能恢复。     

行气温阳散烫熨治疗糖尿病神经源性膀胱的效果观察

目的观察行气温阳散烫熨治疗糖尿病神经源性膀胱病变的临床疗效及其安全性。方法将70例糖尿病神经源性膀胱患者随机分为观察组（36例）和对照组（34例）,观察组采用行气温阳散烫熨疗法,对照组肌内注射维生素B1、B12以及酚妥拉明静脉滴注治疗,治疗2个疗程后观察患者残余尿量及自觉症状。结果2个疗程后观察组残余尿量显著少于对照组（P〈0．01）。疗效显著优于对照组（P〈0．01）。结论行气温阳散烫熨治疗糖尿病神经源性膀胱疗效较好;中药烫熨治疗患者无痛苦,无创伤,易被患者接受。     

Transurethral resection of bladder neck in female patients with neurogenic bladder

Transurethral resection of the bladder neck was performed in 6 female patients with neurogenic bladders who presented with a large volume of residual urine and bladder neck obstruction on voiding cystourethrography without detrusor hyperreflexia on cystometry. In 4 of the patients, transurethral sphincterotomy was performed concomitantly. Five of the patients demonstrated significant improvement in bladder emptying and 4 did not need self-catheterization. No complications of the operation were observed.     

女性糖尿病患者膀胱功能障碍的尿动力学研究

目的：探讨尿动力学检查在糖尿病患者膀胱功能障碍诊断中的意义。方法：回顾性分析32例女性糖尿病膀胱病变患者的临床资料和尿动力学检查结果,明确尿动力学的特征性改变。结果：早期组最大尿流率、膀胱容量下降,逼尿肌压力增加,初始尿意、剩余尿量正常;晚期组最大尿流率、逼尿肌压力下降明显,初始尿意、剩余尿、膀胱容量显著增加。结论：女性伴有下尿路症状（LUTS）的糖尿病患者膀胱功能异常的发生率高,随着病程延长,膀胱功能改变明显。尿动力学检查可以明确膀胱功能,对合并糖尿病的LUTS患者的正确诊断和治疗具有重要的指导意义。     

Effect of Robaveron tablet (KN-7) in the long-term therapy for urinary disturbances

Long-term therapeutic effect of Robaveron tablet (KN-7) was studied on 10 female patients of middle and old age with ptosis of urinary bladder and 9 patients with neurogenic bladder. The patients had mainly complained of such subjective symptoms as pollakisuria, difficulty of urination, sense of residual urine, lower abdominal discomfort and urinary incontinence. Robaveron tablet was administered at 2 tablets t.i.d. for 3-26 months. And the drug efficacy was evaluated by residual urine, cystometric findings and subjective symptoms. A significant decrease in the residual urine rate and a significant increase of pressure amplitude were obtained, and improvement of subjective symptoms was seen with an effective rate of about 70%. Overall effectiveness, rated slightly improved or better was 89.5%. No cases of side effects or abnormalities in laboratory tests were observed. Robaveron tablet is safe and effective for patients with urinary disturbance accompanied by ptosis of urinary bladder, as a myogenic disorder, as well as neurogenic bladder in the long-term therapy.     

经尿道内括约肌切除术在神经源性膀胱患者中的应用及长期随访研究

目的:治疗神经源性膀胱的首要两大目的即保护上尿路功能,获得或保持最恰当的尿控能力,但目前缺乏完美的治疗方法.为评价经尿道内括约肌切除术在神经源性膀胱患者中的应用及长期效果,行本研究.方法:回顾性分析2010年6月-2019年6月在我院接受经尿道内括约肌切除术治疗的17例神经源性膀胱患者的临床资料,其中男9例,女8例,年...     

前列腺电切治疗低龄前列腺中叶增生（附12例报告）

目的：探讨经尿道前列腺电切术（TURP）治疗低龄（50岁以下）男性因前列腺中叶增生引起膀胱出口梗阻（BOO）的可行性。方法：应用TURP治疗低龄前列腺中叶增生患者12例,对手术前后最大尿流率（Qmax）、剩余尿量（PVR）、国际前列腺症状评分（IPSS）、男性勃起功能评分（IIEF-5）、精液量等指标进行统计学分析。结果：术后梗阻症状全部消失,4个月后IPSS评分、Qmax及PVR差异均有统计学意义（P〈0．01）,IIEF评分,精液量测定差异无统计学意义（P〉0．05）,无一例逆行射精。结论：TURP治疗低龄前列腺中叶增生所致BOO疗效明显、简单、安全,有临床意义。     

Transurethral electroincision of bladder neck in female patients with neurogenic bladder.

Transurethral electroincision of the bladder neck in female patients with neurogenic bladders has not been widely reported. We have performed this operation on 21 patients who have failed to achieve balanced bladder function through other treatment modalities and who have presented with recurrent urinary tract infections, high postvoid residual urine, and evidence of upper urinary tract deterioration. Eighty-five per cent of female patients treated in this fashion have demonstrated significant improvement in bladder emptying. The rate of complication has been low, and no cases of persistent incontinence have occurred. We recommend this operation in difficult cases of neurogenic bladder in females.     

Clinical effects of oxybutynin hydrochloride on neurogenic bladder

Clinical effects of oxybutynin hydrochloride on lower urinary tract function at a dosage of 2 mg given orally three times daily (6 mg/day), were studied on 10 patients with neurogenic bladder by cystometry and measurement of residual urine. There was a significant increase, of about 34% in FDV, but no significant changes in MBV, or maximum voiding pressure of residual urine after administration. Urinary frequency, incontinence and urgency in subjective symptoms were decreased in patients given this drug. The effective rate (excellent and good) was 50% in global evaluation. Side effects were observed in 4 out of 10 patients; 3 had dry mouth and 1 had diarrhea. There were no serious side effects. These findings suggested that oxybutynin hydrochloride may be a useful drug for neurogenic bladder.     

Neurogenic bladder dysfunction due to spina bifida and sacral dysgenesis manifested itself in middle age. Report of a case

Congenital neurogenic bladder dysfunction with spina bifida and sacral dysgenesis manifested itself at middle age is reported. A 48-year-old male who had urinary retention and suprapubic cystostomy one year and a half before in another hospital was seen, asking for removal of the cystostomy. He had never had any neurologic or bladder dysfunction in his childhood and adulthood. X-ray examination revealed a bifid spine and sacral dysgenesis, bilateral hydronephrosis, bilateral VUR and urethral stricture. Uroflowmetry showed a severe dysuric pattern (voided volume 5 ml, residual urine 230 ml) and the cystometrogram revealed a hyperactive bladder. Optical urethrotomy for stricture yielded some improvement i.e. recovery of voluntary voiding with large amount of residual urine. TUR of the bladder neck resulted in almost complete voiding. Cohen's antireflux operation yielded favorable improvement of hydronephrosis. The bladder and renal function remained favorable in the follow-up period of about two years. The clinical course of this patient suggested that his bladder dysfunction was due to late manifestation of congenital neurogenic bladder.     

综合康复训练在重建脊髓损伤患者膀胱功能的临床研究

【摘要】 目的 探讨综合康复训练对促进脊髓损伤患者神经源性膀胱功能重建的临床疗效。方法〓选择71例神经源性膀胱患者,分成实验组(36例)和对照组(35例),实验组采用间歇性导尿和综合康复训练,包括Crede手法按摩、耻骨上区轻叩法、扳机点法及电针刺激法等康复训练,对照组则采用留置导尿法和综合膀胱功能训练,并进行比较两组患者疗效比较。结果〓与对照组相比,实验组的尿路感染较明显减少,膀胱容量与残余尿量亦接近正常水平。结论〓脊髓损伤患者采取神经源性膀胱的综合康复功能训练和间歇性导尿的等模式,有助于提高脊髓损伤患者的生存质量。