早期发现,onabotulinumtoxinA用于控制膀外缩的术后疼痛
Jason Yang1, Chad B Crigger1, Catherine Robey1
1Robert D. Jeffs Division of Pediatric Urology, James Buchanan Brady Urological Institutions, Johns Hopkins Hospital, Johns Hopkins Medical Institutions, Charlotte Bloomberg Children's Hospital, Baltimore, MD, USA.
Journal of pediatric urology
|May 30, 2025
概括
在没有尿路支架的膀重建过程中,onabotulinumtoxinA (博托克斯) 注射有效地减少了对止痛药的需求,并改善了在外缩症患者的疼痛评分. 博托克斯没有显示出对外关闭或用尿路支架进行重建的显著益处.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 儿科手术 儿科手术
- 疼痛管理 疼痛管理
背景情况:
- 膀重建和外关闭后的术后疼痛管理是复杂的.
- 阿片类药物和抗胆固醇药物是标准的,但具有长期使用并发症的风险.
研究的目的:
- 评估OnabotulinumtoxinA (博托克斯) 在患有经典膀外缩 (CBE) 和阴道外缩 (CE) 的患者的术后益处.
- 评估博托克斯对疼痛管理和膀重建和外收缩关闭期间的药物需求的影响.
主要方法:
- 对接受膀重建或异构闭塞的CBE和CE患者的回顾性审查 (2018-2024年).
- 膀重建包括诸如膀部重建和增大等手术.
- 患者根据需要尿管支架的同时尿管再植入物进行了分层.
主要成果:
- 在没有尿路支架的膀重建中,博托克斯显著减少了氧丁宁和氧的使用.
- 这些患者也经历了较少的疼痛得分升高的日子 (疼痛>0和疼痛>4).
- 在用尿管支架重建或在外闭合时,没有观察到药物使用或疼痛评分的显著差异.
结论:
- 玻尿酸毒素A (博托克斯) 改善了术后结果,并减少了在没有需要支架的尿路再植入的情况下接受膀重建的前症患者的药物使用.
- 博托克斯在外关闭或涉及用支架重新植入尿道的重建中没有显示出显著的术后优势.
- 博托克斯在精选的外重建中显示出作为术后疼痛管理的辅助剂的潜力.
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