朱红军，杨卫新，苏楠，刘传道，昝云强.肉毒毒素注射尿道外括约肌对逼尿肌 尿道外括约肌失协调患者逼尿肌厚度的影响[J].中华物理医学与康复杂志,2016,38(6):421-424
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| 肉毒毒素注射尿道外括约肌对逼尿肌 尿道外括约肌失协调患者逼尿肌厚度的影响 |
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| DOI： |
| 中文关键词: 肉毒毒素A 逼尿肌厚度 脊髓损伤 逼尿肌-尿道外括约肌失协调 |
| 英文关键词: Botulinum toxin A Detrusor wall thickness Spinal cord injury Detrusor-sphincter dyssynergia |
| 基金项目:Cyrus Tang Foundation（USA）资助 |
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| 中文摘要: |
| 目的 观察肉毒毒素A（BTX-A）注射尿道外括约肌对脊髓损伤后逼尿肌-尿道外括约肌收缩失协调（DSD）患者逼尿肌厚度及膀胱功能的影响。 方法 选取脊髓损伤后DSD成年患者21例，所有患者均在会阴超声引导下向尿道外括约肌注射BTX-A（100U）。于治疗前、治疗后4周、8周时进行尿动力学检查和下尿道超声评估，测定患者逼尿肌厚度、逼尿肌漏尿点压、残余尿量及最大膀胱容量。 结果 治疗后4周时入选患者残余尿量显著下降（P<0.05），而逼尿肌厚度、逼尿肌漏尿点压及最大膀胱容量均无明显改变（P>0.05）。治疗后8周时入选患者逼尿肌厚度为（0.93±0.17）mm，较治疗前下降了17.2%（P<0.05）；逼尿肌漏尿点压、残余尿量及最大膀胱容量亦较治疗前明显改善（P<0.05）。 结论 在超声引导下向尿道外括约肌注射BTX-A可显著降低脊髓损伤后DSD患者逼尿肌厚度，改善膀胱功能，该疗法值得临床推广、应用。 |
| 英文摘要: |
| Objective To evaluate the effect of injecting botulinum toxin A (BTX-A) to the external urethral sphincter on detrusor wall thickness (DWT) and the bladder function of spinal cord injury patients with detrusor-sphincter dyssynergia (DSD). Methods Twenty-one adult patients with DSD due to spinal cord injury were recruited. A single 100 IU dose of botulinum toxin A was injected into their external urethral sphincters via an ultrasound-guided transperineal route. DWT, detrusor leak-point pressure (DLPP), post-void residual volume (PRV) and maximum bladder capacity(MBC) were assessed by urodynamic examination and ultrasound evaluation before and 4 and 8 weeks after the injection. Results Four weeks later a significant decrease in PRV was observed, but no significant difference in DWT, DLPP or MBC. After eight weeks the mean DWT value had decreased by 17%, a significant reduction. There were also significant improvements in DLPP, PRV and MBC at eight weeks compared with the of baseline values. Conclusions BTX-A injection to the external urethral sphincter can reduce DWT and improve bladder function in spinal cord injury patients with DSD. |
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