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目的 探讨反射亢进型神经源性尿失禁的外科治疗及康复训练方法。方法 于1992年1月至2000年10月治疗81例反射亢进型神经源性尿失禁患儿,男54例,女27例,年龄4～14岁,术前检查均证实盆底肌松弛,膀胱容量较小。采用双侧髂腰肌加强盆底肌,回肠去粘膜带血管蒂浆肌层补片的基础上,行膀胱扩大术进行治疗,其中5例行锤状肌膀胱颈悬吊。结果 81例随访6个月～7年,尿失禁症状明显改善63例,术后经过严格的训练有改善的18例。但其中2例效果较差。结论 双侧髂腰肌加强盆底肌,回肠去粘膜带血管蒂浆肌层补片加强膀胱逼尿肌基础上行膀胱扩大术是治疗小儿反射亢进型神经源性尿失禁的较好方法,术后必须进行正规的康复功能训练。
Objective To investigate the surgical treatment and rehabilitation training of hyperthyroidism with urinary incontinence. Methods From January 1992 to October 2000, 81 cases of hyperreflexic neurogenic urinary incontinence were treated in our hospital. There were 54 males and 27 females, aged 4-14 years. Preoperative examination confirmed pelvic floor muscle relaxation and bladder Small capacity. Bilateral iliopsoas muscle was used to strengthen the pelvic floor muscle, ileum mucosa with vascular pedicle muscle patch on the basis of bladder expansion surgery, of which 5 cases of hamstring muscle neck suspension. Results 81 cases were followed up for 6 months to 7 years, urinary incontinence symptoms were significantly improved in 63 cases, after training after rigorous training have improved in 18 cases. However, two of them were less effective. Conclusions Bilateral iliopsoas muscle strengthening pelvic floor muscle, ileum mucosa with vascular pedicle muscle patch to strengthen the bladder detrusor basic bladder enlargement is a good method for the treatment of children with hyperreflexic neurogenic urinary incontinence after surgery Must be formal rehabilitation training.