神经移植术治疗截瘫神经性膀胱的尿动力学观察

目的　评价神经转位移植术治疗陈旧性截瘫神经性膀胱病人的手术效果。　方法　回顾性分析40例胸腰段骨折致截瘫神经性膀胱病人肋间血管神经转位桥接骶神经根35例、尺神经转位吻合阴部神经5例手术前后尿动力学检测结果。　结果　骶根组35例术前最大尿流率(Qmax)均低于正常，术后20例恢复正常（57%），10例明显改善(28.6%)，术前后逼尿肌最大收缩力分别为（60±15cmH

An urodynamic evaluation of neuroanastomosis for neurogenic bladder caused by spinal cord injury

Objective To evaluate neuroanastomosis for neurogenic bladdercaused by spinal cord injury. Methods An urodynamic evaluation was made for neuroanastomosis carried out for 40 cases of spinal cord injury with neurogenic bladder and paraplegia.In 35 cases,the intercostal nerve was bridged to the sacral root (SR group) and in 5 the ulnar nerve was anastomosed to the pudental nerve (PUD group). Results In the SR group,the preanastomosis Qmax was below the normal while it reached to normal range after neuroanastomosis in 20 (57%) and was obviously improved in another 10 (28.6%).The maximum detrusor contraction pressure increased of pre-and postoperetion was 60±15 cmH2O and 120±35 cmH2O respectively (P<0.05). The incidence of detrusor areflexia and poor compliance decreased (P<0.05).In the PUD group,detrusor reflex and vesical-sphincter synergia were recovered in 2. Conclusions The vesical-urethral function has been greatly improved in most patients.Urodynamic evaluation especially uroflow rate and cystometry is important in the follow up studies of spinal cord injury with neurogenic bladder and paraplegia.