摘要
目的：观察膀胱壁内注射A型肉毒毒素治疗脊髓损伤患者神经原性膀胱的临床效果。方法：78例脊髓损伤后神经原性膀胱患者，男59例，女19例，平均年龄38．9岁。将300单位A型肉毒毒素溶解于15ml生理盐水，使用膀胱镜注射针分30个点注射于膀胱壁，0．5ml／点。治疗前后均记录患者排尿日记，并观察药物毒副作用。结果：78例患者经第1次治疗后平均尿失禁次数由13．5次／d降至2．7次／d、平均导尿量由131ml／次增至389ml／次，平均尿失禁量由1690ml／d降至281ml／d，起效的平均时间为7．6d。10例患者在第1次注射8．9个月后接受第2次注射，平均尿失禁次数由9．7次／d降至3．7次／d，平均导尿量由108ml／次增至387ml／次。6例患者在第2次注射后5．8个月接受第3次注射，平均尿失禁次数由9．2次／d降至3．9次／d，平均导尿量由116ml／次增至364ml／次。随访期间未观察到任何毒副作用。结论：经尿道膀胱壁内A型肉毒毒素注射是治疗脊髓损伤患者神经原性膀胱的有效、安全、可多次重复应用的微创方法。
Objective：To evaluate the effects of botulinum-A toxin （BTX-A） injected into bladder wall to deal with neurogenic bladder associated with spinal cord injury（SCI）.Method：Seventy-eight patients with SCI, male 59,female 19,with the mean age of 38.9 years,were included in the study.All patients wrote down the voiding diary,and underwent the urodynamic examination.300IU BTX-A was dissolved in 15ml normal saline, and the solution of BTX-A was injected into 30 different points （0.5ml/point） in detrusor using a flexible cystoscopic needle.The voiding diary and side effects were evaluated.Result：After the first injection of BTXA,the frequency of incontinence decreased from 13.5 to 2.7 times per day,the volume of incontinence reduced from 1690ml to 281ml,the volume for intermittent catheterization（IC） increased from mean 131ml to 389ml.10 cases received the second injection in 8.9 months after the first one;incontinence decreased from 9.7 to 3.7 times per day,the volume for IC increased from mean 108ml to 387ml.6 cases received the third injection in 5.8 months after the second one;incontinence decreased from 9.2 to 3.9 times per day,the volume for IC increased from mean 116 ml to 364 ml.No side effects were observed.Conclusion：It suggests that Botulinum-A toxin injected into bladder wall to treat neurogenic bladder in the patients with SCI is an effective,safe,repeatable solution.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
2005年第12期719-721,共3页
Chinese Journal of Spine and Spinal Cord
关键词
A型肉毒毒素
膀胱壁
神经原性膀胱
脊髓损伤
Botulinum-A toxin
Bladder wall： Neurogenic bladder
Spinal cord injury
