脊髓损伤后神经源性膀胱的康复治疗进展

Progress in Rehabilitation Treatment of Neurogenic Bladder after Spinal Cord Injury

摘要: 神经源性膀胱(neurogenic bladder, NB)是脊髓损伤(spinal cord injury, SCI)的临床常见合并症之一。膀胱功能障碍引起的肾功能衰竭是脊髓损伤患者死亡的第一位原因。因此，重建平衡的膀胱功能和提高控尿能力是脊髓损伤患者康复治疗中一项重要内容，对于提高患者生活质量，延长预期寿命具有重要的意义。神经源性膀胱的康复治疗包括药物疗法、手术疗法、电刺激疗法、磁刺激疗法以及康复训练疗法等。尿流动力学检查已成为脊髓损伤后膀胱尿道功能障碍的常规检查技术，通过尿流动力学检查可对膀胱尿道功能进行分类外，还可为临床的诊断、治疗及疗效评价提供更多的客观指标。本文将近些年来脊髓损伤后神经源性膀胱康复治疗研究的成果进行概述，总结出脊髓损伤后神经源性膀胱的治疗是复杂的综合工作，间歇性导尿、膀胱功能训练等已经是比较成熟的治疗手段，但目前仍没有一种方法可以使神经源性膀胱功能完全恢复。

Abstract: Neurogenic bladder is one of clinical common complication of spinal cord injury. To improve the patients’ quality of life and reduce mortality, reconstruction of spinal cord injury patients with bladder function has important significance. NB rehabilitation treatment includes rehabilitation training therapy, drug therapy, electrical stimulation therapy, magnetic stimulation therapy, etc. Urodynamic testing has become a routine inspection of bladder dysfunction after spinal cord injury, neurogenic bladder can be categorize through the test, besides, it still can provide more objective indicators of clinical diagnosis, treatment and curative effect evaluation. This article is to summarize the latest research results of rehabilitation in spinal cord injury. Various treatments for neurogetic bladder were introduced and their treatment results were critically reviewed. Summarily, the treatment of neurogenic bladder after spinal cord injury is an integrated and complex work, which no satisfying treatment is available. Bladder function training and intermittent catheterization are common method.