STUDY DESIGN:Retrospective study. OBJECTIVES:To analyze the neurogenic bladder characteristics and treatment approaches in patients with upper and lower cervical spinal cord injury (SCI) in order to make proper and reasonable decisions to the relevant patients. SETTING:Rehabilitation center in Ankara, Turkey. METHOD:Ninety patients with cervical SCI were included. The urodynamic analyses of the patients were conducted retrospectively by using the urodynamic laboratory records. The patients were divided into two groups as the upper cervical SCI (UCSCI) group (C1-C5) and lower cervical SCI (LCSCI) group (C6-C8). RESULTS:In this study, 82 male (91.1%) and 8 (8.9%) female patients were included. There were 51 UCSCI patients with the mean age of 34.2 ± 16.1 years and 39 LCSCI patients with the mean age of 30.4 ± 12.5 years. Detrusor overactivity and preservation of the bladder-filling sensation were significantly more frequent in the UCSCI group than in the LCSCI group (P=0.048, P=0.000 respectively). Moreover, there were statistically significant differences between the groups regarding the bladder-emptying methods, residual volume and the frequency of anticholinergic and alpha blocker use (all P<0.05). No significant difference was found between the groups regarding the frequency of autonomic dysreflexia, detrusor hypocompliancy and the bladder-storage and -emptying disorders (all P>0.05). CONCLUSION:Our results demonstrate that there are differences in the upper and lower SCI cases in terms of neurogenic bladder characteristics and treatment approaches.

译文

研究设计:回顾性研究。
目的:分析上下颈脊髓损伤(SCI)患者的神经源性膀胱特征和治疗方法,以便对相关患者做出正确合理的决定。
地点:土耳其安卡拉的康复中心。
方法:纳入90例宫颈SCI患者。使用尿流动力学实验室记录对患者进行尿流动力学分析。将患者分为上颈SCI(UCSCI)组(C1-C5)和下颈SCI(LCSCI)组(C6-C8)两组。
结果:本研究纳入了82例男性患者(91.1%)和8例患者(8.9%)。 UCSCI患者51例,平均年龄34.2±16.1岁,LCSCI患者39例,平均年龄30.4±12.5岁。与LCSCI组相比,UCSCI组的逼尿肌过度活动和膀胱充盈感的保持明显更为频繁(分别为P = 0.048,P = 0.000)。此外,各组之间在膀胱排空方法,残留量以及抗胆碱能药和α-受体阻滞剂的使用频率上有统计学差异(均P <0.05)。两组之间在自主神经反射不良,逼尿肌功能不全以及膀胱存储和排空障碍的发生率上无显着差异(所有P> 0.05)。
结论:我们的结果表明,就神经源性膀胱特征和治疗方法而言,上下SCI病例存在差异。

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