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目的:随访、复查腰骶部囊性脊柱裂术后患儿,观察神经源性膀胱发病情况。方法:对38例行尿流动力学、排尿性膀胱尿道造影、B 超及(或)静脉尿路造影检查。结果:①脊髓脊膜膨出占囊性脊柱裂的62%,脊髓脊膜膨出并发神经源性膀胱发病率为96%;②骨质缺损≥1.5cm×1.5cm 者多为脊髓脊膜膨出(P<0.005);③共有8例上尿路功能受损者,残余尿最均≥60ml,其中4例充盈期膀胱内压力≥1.96kPa(20cm H_2O),而3例膀胱逼尿肌-尿道括约肌协同失调者全部出现膀胱输尿管返流。结论:①腰骶部囊性脊柱裂骨质缺损≥1.5cm×1.5cm 者易并发神经源性膀胱;②充盈期膀胱内压力增高、膀胱逼尿肌-尿道括约肌协同失调、残余尿量明显增多是上尿路功能受损的危险因素。
OBJECTIVE: To follow up and review the children with lumbosacral cystic spina bifida to observe the incidence of neurogenic bladder. Methods: Thirty-eight patients underwent urodynamics, urinary bladder and urethrography, B ultrasound and / or venous urography. Results: ① Spinal meningocele accounted for 62% of cystic spina bifida, the incidence of spinal meningocele complicated with neurogenic bladder was 96%; ② bone defects ≥ 1.5cm × 1.5cm mostly spinal dural swelling (P <0.005). (3) A total of 8 patients with impaired upper urinary tract function had the most residual urine more than or equal to 60ml. Among them, 4 patients underwent bladder pressure ≥1.96kPa (20cm H_2O) Urethral sphincter dysfunction, all with vesicoureteral reflux. Conclusions: ①The lumbosacral cystic spine fractures are more than 1.5cm × 1.5cm in patients complicated with neurogenic bladder; ② During the filling period, the intravesical pressure increases and the detrusor-urethral sphincter of the bladder contracts and the residual urine volume increases significantly Is a risk factor for impaired upper urinary tract function.