46例脊髓损伤患者并发肾积水的疗效分析

目的 探讨脊髓损伤并发肾积水的最佳治疗途径。方法 46例患者分别采用留置尿管、间歇导尿和药物疗法、综合方法进行治疗，观察肾积水缓解所需的治疗时间和复发情况。结果 3种治疗方法所需的治疗时间无差异；逼尿肌反射亢进合并括约肌痉挛（DSD）的复发率（85．7％）高于逼尿肌的反射亢进者（35％）和低下者（25％）。结论 建议首选间歇导管和药物疗法治疗轻、中度肾积水，以避免长期留置尿管的并发症；SCI并发肾积水隐匿且易复发，早期B超检查有助于尽早发现肾积水；早期治疗预后较佳；尿流动力学检查结果对SCI肾积水的处理有指导意义。

Retrospective analysis of effect of treatment on hydronephrosis in 46 spinal cord injured patients

ObjectiveTo search for the optimal treatment of hydronephrosis after spinal cord injury .Methods46 cases were treated by indwelling catheter, intermittent catheterization and drug therapy, and comprehensive therapy respectively. The course of treatment and the recurrence rate were observed after hydronephrosis remitted. Results There were no differences in the course of treatment among the three different kinds of therapy. The recurrence rate of the detrusor sphincter dyssynergia(85.7%) was higher than that of the detrusor hyperreflexia (35%) and the detrusor hyporeflexia(25%).ConclusionsThe optimal therapy on slight and moderate hydronephrosis should be intermittent catheterization and drug therapy to avoid the complications of long term indwelling catheter. SCI hydronephrosis is indistinct and recurrent easily. B ultrasound for kidneys is helpful in discovering SCI hydronephrosis on early stage. The earlier the treatment, the better the prognosis. Urodynamics plays an important role in the management of SCI hydronephrosis.