还想对Beaumont提个要求:


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送交者: 羽矢 于 2010-11-07, 12:07:40:

回答: 有两处: 由 羽矢 于 2010-11-07, 10:50:42:

We request doctors at Beaumont, instead of continuing their clinical trial, to do a historic review on the closely related conventional treatments of neurogenic bladders - denervation and/or detethering, and compare their results to that of those treatments.


选择性骶神经切断术文献(Dr. Eric Kurzrock在编辑评论中提供):
http://www.ncbi.nlm.nih.gov/pubmed/3359125
[2]. Lucas MG, Thomas DG, Clarke S et al: Long-term follow-up of selective sacral neurectomy. Br J Urol 1988; 61: 218.
Thirteen of the 22 patients had significant symptomatic improvement lasting for more than 4 years post-operatively (59%), 8 of whom had stable bladders.
http://www.ncbi.nlm.nih.gov/pubmed/11445474
[3]. Hohenfellner M, Pannek J, Botel U et al: Sacral bladder denervation for treatment of detrusor hyperreflexia and autonomic dysreflexia. Urology 2001; 58: 28.
Detrusor hyperreflexia and autonomic dysreflexia were eliminated in all cases. ...

解栓术文献(google scholar搜索结果头两条):
http://scholar.google.com/scholar?hl=en&q=detethering+bladder+control
[1] von Koch CS, Quinones-Hinojosa A, Gulati M, Lyon R, Peacock WJ, Yingling CD. Clinical outcome in children undergoing tethered cord release utilizing intraoperative neurophysiological monitoring. Pediatr Neurosurg. 2002 Aug;37(2):81-6.
25名患者中的4名,大小便显著改善。(Significant bowel and bladder improvement was seen in 4 out of 25 patients)
[2] Hsieh MH, Perry V, Gupta N, Pearson C, Nguyen HT. The effects of detethering on the urodynamics profile in children with a tethered cord. J Neurosurg. 2006 Nov;105(5 Suppl):391-5.
10名术前尿动力学结果异常的患者中的5名,术后尿动力学研究表现出改善或正常的尿动力学数据(in five (50%) of the 10 children with abnormal preoperative UDS results, the postoperative UDS demonstrated improved or normal urodynamics.)

解栓术+选择性骶神经切断术治疗脊柱裂后尿失禁:
Schneidau T, Franco I, Zebold K, Kaplan W. Selective sacral rhizotomy for the management of neurogenic bladders in spina bifida patients: long-term followup. J Urol. 1995 Aug;154(2 Pt 2):766-8.
In 1992, 2 of us (I.F. and W.K.) first reported results with selective sacral rhizotomy and cord untethering in 8 spina bifida patients. We report long-term followup of our original 8 patients and 3 additional patients. This followup demonstrates remarkable success in maintaining bladder volume and low pressures after rhizotomy and cord untethering. Uninhibited contractions resolved in all patients postoperatively. A more favorable response occurred in the patients younger than 9 years, supporting early intervention with selective sacral rhizotomy.




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