摘要
目的 探讨合并神经原性膀胱活动低下（NUB）非瘫痪脊髓功能障碍（NPSCD）患者肠道膀胱扩大术（ECP术）后生命质量评估和尿动力学参数改善情况.方法 采用SF-36问卷表对72例合并NUB的NPSCD患者进行生命质量评分,并依据尿动力学膀胱功能障碍类型行ECP术联合自我清洁间歇导尿（CISC）或单一CISC治疗,最终对完成1年生命质量评分和尿动力学检查的58例（81%）患者[男30例（平均27±5岁）,女28例（平均26±4岁）]进行随访.选取40例无明显排尿异常症状正常志愿者[男20例（平均28±4岁）和女20例（平均29±4岁）]为对照组.结果 随访时,男女患者生理职能、生命力和社会功能得分分别为55±14和45±15、76±19和74±15、52±19和59±13,均显著高于治疗前35±10和32±11、27±18和33±17、40±12和34±15;最大膀胱压测定容量和膀胱顺应性分别为（320±44）和（338±50）ml、（55±15）和（60±17）cm H2O,显著高于治疗前的（131±30）和（140±35）ml、（5±3）和（6±4）cm H2O;逼尿肌漏尿点压分别为（6±2）和（6±3）cm H2O,显著低于治疗前的（28±9）和（25±6）cm H2O,治疗前后差异均有统计学意义（P＜0.05）;但男女生理职能、总体健康、生命力、社会功能、情感职能和精神健康评分均显著低于对照组（P＜0.05）;男女分别仅有17%和7%认为健康状况＂比1年前稍好＂.合并反流性上尿路损害患者随访时男女上尿路情况分别有89%和76%出现不同程度改善. 结论合并NUB的NPSCD患者应用ECP术和CISC治疗尿动力学参数显著改善,但生命质量仍较低,迫切需要更有效地治疗方法.
Objective To investigate the change of quality of life and urodynamics after the enterocystoplasty combined with clean intermittent self-catheterisation （CISC） in nonparalytic spinal cord dysfunction （NSCD） patients with neurogenic underactive bladder by the Medical Outcomes study 36-item short-form general health survey （SF-36）. Methods The quality of life of 72 NSCD patients with NUB were measured by SF-36 questionnaire, who had been taken enterocystoplasty combined with CISC or only CISC according to urodynamic results. In total, 58（81% ） patients were successfully followed for one year by SF-36 questionnaire and urodynamic examination, including 30 men （mean age 27±5 year） and 28 women （mean age 26±4 year）. The normal volunteers without lower urinary tract symptom were set as control group, including 20 men （mean age 28 ± 4 year） and 20 women （mean age 29±4 year）. Results At the follow-up, physical role, vitality and social function of men and women were 55±14 and 45±15, 76±19 and 74±15, 52±19 and 59±13 respectively, significantly higher than those before the treatment （35 ± 10 and 32 ±11, 27 ± 18 and 33 ± 17, 40 ±12 and 34 ±15）. The bladder compliance and maximum cystometric capacity were （320 ± 44 ） ml and （ 338 ±50）ml,（55±15）cm H2O and （60±17）cm H2O respectively, also significantly higher than those before the treatment （131±30ml and 140±35ml,5±3 cm H2O and 6±4 cm H2O）. However, detrusor leakage point pressures were （6±2）cm H2O and （6±3）cm H2O respectively, significantly lower than those before the treatment （28 ±9 cm H2 O and 25 ± 6 cm H2O）. Except for physical function and bodily pain, the all domains of quality of life in both men and women patients were significantly lower than those in control group. Only 17 % of men and 7 % of women believed ＂their health is better than that one year ago＂. There was no significant difference in the remission rate between men and women （89% vs 76%） in the patients w
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2010年第6期405-409,共5页
Chinese Journal of Urology
