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口服抗胆碱药已用于控制神经原性膀胱和尿失禁病儿的逼尿肌反射亢进,并取得了一定的效果。但不是所有的病儿都有效,即使用了很大剂量,由于膀胱内高压以及低容量在两次导尿间仍有尿失禁。此外,由于口干,不能耐热、情绪改变、失眠,便秘、白天嗜唾等副作用,一些人不能耐受口服抗胆碱药。作者采用膀胱内灌注羟丁宁(oxybutynin chlovide)法治疗了10例病人(脊柱裂9例,无肛1例),其中男7例,女3例,年龄4-18岁。所有病人都无自主排尿,均以间歇导尿(清醒时每3-6小时一次)方式排小便。7例口服大剂量的羟丁宁,3例不能耐受。10例病人昼夜均有尿失禁,都用尿布。治疗方法为用5mg羟丁宁溶于10ml灭菌生理盐水内灌注膀胱每日早晚各1
Oral anticholinergic drugs have been used to control detrusor hyperreflexia in children with neurogenic bladder and urinary incontinence and have achieved some results. But not all sick children are effective, even with a very large dose, due to intravesical high pressure and low volume of urinary incontinence still in between two catheterization. In addition, some people can not tolerate oral anticholinergic drugs due to dry mouth, lack of heat tolerance, mood changes, insomnia, constipation, side effects such as saliva during the day. The authors treated 10 patients (9 with spina bifida, 1 without anus) by intravesical instillation of oxybutynin, with 7 males and 3 females, aged 4-18 years. All patients without involuntary urination were intermittent catheterization (awake every 3-6 hours once) row of urine. 7 cases of oral high-dose oxybutynin, 3 cases can not tolerate. Ten patients had urinary incontinence all day and night, both with diapers. Treatment is with 5mg oxybutynin dissolved in 10ml sterilized saline intravesical instillation of the bladder daily 1