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在外科手术期间进行的bulbocavernosus反射监测,用于预测患有远端脊髓内瘤的患者的术后排泄功能障碍
Tuanfeng Yang1, Kehan Jin1, Desheng Kong2
1Department of Neurology, Peking University International Hospital, Beijing, China.
概括
在手术期间进行的球穴内反射 (BCR) 监测可靠地预测脊髓瘤患者的手术后排泄功能障碍. 保持BCR表明尿功能良好,6个月是评估的最佳时间.
科学领域:
- 神经外科 神经外科
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 临床神经生理学 临床神经生理学
背景情况:
- 远端脊内瘤可能会导致显著的术后排泄功能障碍.
- 准确预测排泄功能障碍对于患者管理至关重要.
- 术后监测技术对于在手术期间保持神经功能至关重要.
研究的目的:
- 为了评估术后排泄功能障碍的手术内球穴内反射 (BCR) 监测的预测准确性.
- 为了确定在外科手术后对远端脊内瘤进行尿功能评估的最佳时间.
- 为了确定手术前排泄症状是否会影响术后的结果.
主要方法:
- 分析了一组接受远端脊髓内瘤手术的患者队列,并进行了手术内BCR监测.
- 患者根据手术结束时BCR的存在或不存在来对患者进行分类.
- 在术后1周,2个月,4个月和6个月评估了空洞功能.
主要成果:
- 在手术期间的BCR损失显示,随着时间的推移,预测恶化的排泄功能障碍的灵敏度越来越高 (20%在1周到100%在6个月),具有100%的特异性.
- 在96.2%的患者中保持了BCR;在2例中发生了完全的损失.
- 术前空气难度与术后1周后的结果恶化有关.
结论:
- 术内BCR监测是患有远端脊髓内瘤的患者术后排泄功能障碍的可靠预测指标.
- 保持BCR表明有利的长期泌尿功能.
- 术后6个月的随访为功能评估提供了最佳的灵敏度和特异性.
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