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目的 :探讨小儿神经源性膀胱的手术治疗指征及疗效。方法 :对 2 2例小儿神经源性膀胱的患儿 ,经膀胱测压、尿道测压、冰水实验、膀胱造影等检查 ,确定是逼尿肌无反射 ,且不并发输尿管反流 ,尿道压力在正常范围内者行腹直肌转位术。结果 :本组 2 2例患者 ,2 0例尿失禁症状明显好转 ,能自行排尿 ,剩余尿量明显减少 ,2例尿失禁症状无改善。术后 10例测最大尿流率 >15ml/s。 4例术前肾功能中度受损患儿 ,3例术后肾功能明显改善 ,5例术前肾功能轻度受损患儿 ,4例肾功能恢复正常。结论 :此手术对于保护患儿的肾功能及提高生活质量有较好的作用。是治疗小儿逼尿肌无反射性神经源性膀胱的可行手术方法
Objective: To investigate the indications and curative effect of pediatric neurogenic bladder surgery. Methods: Twenty-two cases of pediatric neurogenic bladder were examined by cystometry, urethral pressure test, ice water test and cystography to determine the detrusor without reflex and without ureter reflux, urethral pressure In the normal range of rectus abdominis transposition surgery. Results: Twenty cases of patients with urinary incontinence showed obvious improvement in their symptoms of urinary incontinence. They could urinate on their own and the remaining urine volume decreased significantly. There was no improvement in the two cases of urinary incontinence. After 10 cases measured maximum flow rate of> 15ml / s. In 4 cases of preoperative renal dysfunction in children, 3 cases of postoperative renal function improved significantly, 5 cases of mild preoperative renal dysfunction in children, 4 cases of renal function returned to normal. Conclusion: This operation has a good effect on the protection of renal function and quality of life in children. It is a feasible surgical method for treating pediatric detrusor reflex-free neurogenic bladder