脊髓栓系伴神经源性膀胱16例诊治

目的：探讨脊髓栓系伴神经源性膀胱的诊治方法。方法：对26例脊髓栓系伴神经源性膀胱患者的临床资料进行回顾性分析，治疗前所有患者均行尿动力学及腰骶MRI检查，均行解栓术，术后排尿症状均有不同程度改善，再依尿动力学结果采取针对性的治疗方法，A型肉毒素膀胱逼尿肌注射术5例，间歇性清洁导尿2例，膀胱扩大术2例。所有患者治疗后均行尿动力学随访。结果：26例获3个月至3年的随访，其中24例膀胱、尿道功能明显改善，2例需一直行间歇性清洁导尿，但无上尿路恶化。结论：对脊髓栓系伴神经源性膀胱的治疗，无论早晚解栓术都是十分必要的，再根据术后排尿症状采取相应的个性化治疗。

Diagnosis and Treatment of 26 Cases of Tethered Cord Combined With Neutogenic Bladder

Objective： To study the diagnoses and treatment of tethered cord combined with neurogenic bladder. Methods： The clinical data of 26 cases of tethered cord with neurogenic bladder was analyzed retrospectively. Before the treatment, all patients underwent urodynamics test and lumbosacral MRI examination. Then, a specific treatment was given to each patient based on their examination results. Among them, bo- tulinum toxin type A was injected into detrusor of bladder on 5 eases, clean intermittent catheterization carfled out on 2 cases and augmentation of bladder was performed on 2 cases. After treatment, all patients were followed-up and urodynamics test was performed at each visit. Results： 26 patients were followed-up for 3 months to 3 years, 24 patients showed an obvious improvement in the bladder and urethral function, 2 patients still need clean intermittent catheterization but no upper urinary tract deterioration was noted. Conclusion： For patients with tethered cord combined with neurogenic bladder, sooner or later solution embolec- tomy is necessary, then the treatment was given individually according to the patients＂ post-op voiding symptoms.