肉毒毒素治疗逼尿肌-外括约肌协同失调

摘要

逼尿肌-外括约肌协同失调是骶髓以上脊髓损伤、多发性硬化患者常见的尿流动力学异常表现,若不及时治疗将严重影响患者生活质量.肉毒毒素作为常见神经毒素,通过抑制含有神经递质的囊泡在神经肌肉接头和神经腺体接头的传递发挥作用.尿道外括约肌注射肉毒毒素通过被动松弛尿道外括约肌短期内有一定的疗效,但是这可能受到患者性别和不同基础疾病病理生理学的影响.本文旨在对肉毒毒素治疗逼尿肌-外括约肌协同失调的机制、安全性、有效性和副作用进行综述.%Detrusor external sphincter dyssynergia (DESD) is common urodynamic findings in patients with suprasacral spinal cord injury,and multiple sclerosis.Patients' quality of life is impacted severely if the condition is not treated appropriately.As a common neurotoxin,botulinum toxin works through inhibiting vesicular neurotransmitter release at the neuromuscular and neuroglandular junctions.External sphincter injections of botulinum toxin were of short-term efficacy by relaxing external sphincter passively.However,efficacy may be affected by pathophysiology of disease states,or the sex distribution of patients.In this study we review the mechanism,safety,efficacy and side effects of botulinum toxin in treating detrusor external sphincter dyssynergia.