脊髓损伤和中风中的神经性空洞功能障碍:尿动力学评估,功能分类和治疗策略
Enmanuel Sevilla Torres1, Edgardo J Soto-Junco2, Santiago Daniel Baizan Orias1
1General Medicine, Universidad de Ciencias Médicas (UCIMED), San José, CRI.
Cureus
|September 5, 2025
概括
在中风或脊髓损伤后经常出现的神经性排泄功能障碍,影响膀控制. 早期诊断和治疗是预防严重并发症和改善患者生活质量的关键.
科学领域:
- 神经科学
- 泌尿外科
- 康复医学
背景情况:
- 神经性排泄功能障碍 (NVD) 是中枢神经系统损伤,特别是中风和脊髓损伤 (SCI) 的常见并发症.
- NVD显著损害了自发性膀控制,导致急迫性,失禁和膀不完全排空等症状.
- 没有治疗的NVD可能会导致严重的健康问题,包括经常性尿路感染,膀损伤和逐渐恶化的病.
研究的目的:
- 提供病理生理学,诊断方法和神经性排泄功能障碍的治疗策略的全面概述.
- 在中风和脊髓损伤的背景下专注于NVD.
- 综合最近的临床研究 (2019-2025年) 以告知当前的管理实践.
主要方法:
- 在2019年至2025年之间发表的最新文献的系统审查.
- 搜索的数据库包括PubMed,Scopus和ScienceDirect.
- 纳入标准集中在临床相关的关于中风和SCI患者NVD的强有力的方法.
主要成果:
- 随着神经损伤的位置和严重程度,NVD的症状有所不同;高层脊髓损伤通常会导致膀过活,而低层损伤可能会导致膀过活.
- 诊断工作通常包括体检,尿动力学研究,尿液流量计和膀超声波.
- 治疗方案包括干净间歇性导管,药物治疗 (抗肌肉毒素,肉毒素),神经调节,以及耐火病例的手术.
结论:
- 有效管理NVD需要涉及护士,治疗师,神经科医生,泌尿科医生和康复专家的多学科方法.
- 为了监测和预防功能衰竭,结石和感染等并发症,必须定期对患者进行随访.
- 及时和适当的干预可以显著改善NVD患者的生活质量和长期健康结果.
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