小儿脊髓脊膜膨出术后尿失禁的手术治疗

摘要

为了总结小儿脊髓脊膜膨出切除术后合并尿失禁的再次手术治疗效果.对小儿脊髓脊膜膨出术后56例全部行椎板减压、神经松解,椎管内肿瘤,各种病理性组织及手术瘢痕切除,切断牵张的终丝,解决脊髓拴系与压迫,恢复血运与神经功能.临床基本治愈33例,有效20例,无效3例.术后无病情加重和死亡.允分的椎板减压,椎裂修补和神经松解,切除病理团块和占位性肿瘤是小儿脊髓脊膜膨出再次手术疗效的关键.%Fifty-six children of meningmyelocele complicated with postoperative urinary incontinence underwent surgery.The main surgical approaches included:(1) vertebrectomy for decompression;(2) neurolysis;(3) space-occupying masses and taut ilium sectioned and adhesions or scars freed;and (4) restoration of neural function and blood circulation.The results showed that favorable outcome was achieved in 33 (58.9%),fair in 20 (35.71%) and poor 3 (5.36%) without operative mortality.The surgical procedures to improve urinary control and rehabilitate sensory and motor disturbance of the lower extremites are discussed.