脊柱裂的神经源性膀胱功能障碍:1例报告及文献综述

N. V. Khudyakova, I. Pchelin, A. Kotrova, A. Shishkin, V. Bayrasheva, V. Smirnov, O. Vasilkova
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引用次数: 2

摘要

脊柱裂是一种由胚胎神经管异常闭合引起的脊髓和/或脊髓发育缺陷。已经描述了许多因素来确定发展这种病理的风险,但缺陷的发生率仍然很高。61%的脊柱裂患者存在基于膀胱内高压的神经源性膀胱功能障碍,这有助于尿道逆流和膀胱-输尿管-肾反流,并与泌尿道慢性炎症和阻塞性疾病相关。25-50%的脊柱裂患者会发展成慢性肾脏疾病,大大降低了他们的生活质量。在某些类型的脊柱裂中,泌尿系统症状可能很突出,表明存在这种畸形。因此,早期诊断脊柱裂并及时采取预防和治疗措施显得尤为重要。本文报告一例后L1-L2型脊柱裂伴闭合性L1-L2脑膜膨出的临床病例,其中泌尿系统症状为主要表现。不能排除本例患者发生神经源性膀胱继发并发症,需密切监测。
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Neurogenic bladder dysfunction in spina bifida: a case report and a brief review of the literature
Spina bifida is a developmental defect of the spinal cord and/or spinal cord that results from abnormal closure of the embryonic neural tube. Many factors have been described to determine the risks of developing this pathology, but the incidence of the defect is still high. 61% of patients with spina bifida have neurogenic bladder dysfunction based on intravesical hypertension, which contributes to reverse urethral flow and vesico-uretero-renal reflux, associated with chronic inflammatory and obstructive diseases of the urinary tract. Between 25-50% of patients with spina bifida develop chronic kidney disease, significantly reducing their quality of life. In some types of Spina bifida, urological symptoms may be prominent and indicate the presence of this malformation. Therefore, early diagnosis of Spina bifida and timely prophylactic and therapeutic measures are particular importance. This article describes a clinical case of Spina bifida posterior L1-L2 with a closed L1-L2 meningocele in which urological symptoms were the dominant manifestation. The development of secondary complications of neurogenic bladder in the presented patient cannot be excluded, which requires closer monitoring.
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