本文關(guān)鍵詞： 兒童 神經(jīng)源性逼尿肌過度活動(dòng) 托特羅定 導(dǎo)尿 尿動(dòng)力學(xué)檢查　出處：《鄭州大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)》2017年06期 　論文類型：期刊論文

【摘要】：目的:評(píng)估托特羅定聯(lián)合清潔間歇導(dǎo)尿(CIC)和夜間留置導(dǎo)尿(CDN)治療兒童神經(jīng)源性逼尿肌過度活動(dòng)(NDO)臨床療效。方法:選取(7.9±2.5)歲NDO患兒44例,按單盲、隨機(jī)法分為觀察組24例(托特羅定聯(lián)合CIC和CDN治療)和對(duì)照組20例(安慰劑聯(lián)合CIC和CDN治療),療程4周。服藥前和治療4周后分別行尿動(dòng)力學(xué)檢查和記錄3 d排尿日記。結(jié)果:共41例患兒完成4周治療。觀察組治療后首次逼尿肌收縮時(shí)容量、膀胱安全容量、膀胱順應(yīng)性及每次導(dǎo)尿量較治療前增大,24 h尿失禁次數(shù)減少(P0.05);對(duì)照組治療后膀胱安全容量、膀胱順應(yīng)性較治療前增大(P0.05);治療后觀察組首次逼尿肌收縮時(shí)容量、膀胱安全容量、膀胱順應(yīng)性、每次導(dǎo)尿量及24 h尿失禁次數(shù)的改善情況均好于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:托特羅定聯(lián)合CIC和CDN治療兒童NDO安全有效,可明顯減少患兒尿失禁次數(shù),改善患兒生活質(zhì)量。
[Abstract]:Objective: to evaluate the clinical effect of tolterodine combined with clean intermittent catheterization (NDO) and nocturnal indwelling catheterization (CDN) in the treatment of neurogenic detrusor hyperactivity (NDOO) in children. The study group (24 cases) were randomly divided into two groups (Totterodine combined with CIC and CDN) and control group (20 cases) treated with placebo combined with CIC and CDN for 4 weeks. Before and after 4 weeks of treatment, urodynamic examination was performed and 3-day row was recorded, respectively. Results: a total of 41 children were treated for 4 weeks. The volume of detrusor contraction in the observation group was the first time after treatment. The safe volume of bladder, bladder compliance and the quantity of urinary catheterization were decreased by 24 h urinary incontinence compared with that before treatment, while in the control group, the safe volume of bladder and bladder compliance were increased after treatment, and the volume of the first detrusor contraction was increased in the observation group after treatment, and there was no significant difference between the treatment group and the control group in the first time of detrusor contraction. The improvement of bladder safety capacity, bladder compliance, urinary volume per catheterization and 24 h urinary incontinence was better than that in control group (P 0.05). Conclusion: Totrodine combined with CIC and CDN is safe and effective in the treatment of NDO in children. It can obviously reduce the number of urinary incontinence and improve the quality of life.
【作者單位】： 鄭州大學(xué)第一附屬醫(yī)院小兒尿動(dòng)力學(xué)中心和泌尿外科;
【基金】：國家自然科學(xué)基金項(xiàng)目81670689
【分類號(hào)】：R726.9

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