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作者报告用外括约肌气囊扩张术治疗一组男性脊髓损伤后逼尿肌外括约肌协同失调(DESD)的结果。7例患者平均年龄29岁(21-39岁),术前行同步膀胱尿道测压和会阴肌电图检查,均证实为DESD。术后1月和4月作尿流动力学检查进行随访;并对术前、术后膀胱容量,残余尿量以及排尿期尿道内压作一比较。操作方法:先用尿道膀胱镜进行外括约肌检查,并排除膀胱畸形。然后经膀胱镜置人导丝,沿导丝将前列腺气囊扩张管放入膀胱。用无菌造影剂充起定位气囊,在透视下将其拉至外括约肌下1-2cm处,使扩张气囊中点到达外括约肌水平。再用无菌造影剂逐渐充起扩张气囊行外括约肌扩张。起初在扩张气囊中点处可见——“细腰征”形成;但当液体注入15ml,压
The authors report the results of an external sphincter balloon dilatation for the treatment of detrusor contractility (DESD) in a group of male patients with spinal cord injury. Seven patients, mean age 29 years (21-39 years), preoperative simultaneous cysto-urethral pressure test and episiotomy EMG examination, were confirmed as DES. Urine hydrodynamic tests were performed at January and April postoperatively. Preoperative and postoperative bladder volumes, residual urine volume, and urethral pressure during voiding were compared. Method of operation: urethral cystoscopy with external sphincter examination, and to rule out bladder malformations. Then set by the cystoscope guide wire, along the guide wire to the prostate balloon dilatation tube into the bladder. Positioning the balloon with aseptic contrast media, pull it 1-2cm below the outer sphincter under fluoroscopy, so that the midpoint of the dilatation balloon reaches the outer sphincter level. Aseptic contrast media and then gradually expand the outer balloon dilatation of the external sphincter. Initially in the middle of the expansion of the balloon can be seen - “waist syndrome” formation; but when the liquid injection 15ml, pressure