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帮肖医生个小忙:肖氏手术的1年随访研究报告

已有 4717 次阅读 2011-4-29 09:23 |系统分类:观点评述| 研究报告, 反射弧, 肖传国

今天凌晨肖传国教授公布了AUA报告的肖氏手术的3年随访研究(详见博文http://blog.sciencenet.cn/home.php?mod=space&uid=385748&do=blog&id=438484),其结果是令人满意的。我由此博文获得了该研究的一些譬如作者、单位等信息。拿来在Pubmed上检索了一下,找到了肖氏手术1年随访研究报告,该报告发表在2010年的Journal of Urology上,该杂志2010年得IF为3.7,我将摘要copy下:
 
J Urol. 2010 Aug;184(2):702-7. Epub 2010 Jun 19.
Outcomes of lumbar to sacral nerve rerouting for spina bifida.
Source

Department of Urology, William Beaumont Hospital, Royal Oak, Michigan, USA.

Abstract PURPOSE:

Restoring bladder and bowel function in spina bifida by creation of a skin-central nervous system-bladder reflex arc via lumbar to sacral nerve rerouting has a reported success rate of 87% in China. We report 1-year results of the first North American trial on nerve rerouting.

MATERIALS AND METHODS:

Nine subjects were enrolled in the study. Intradural lumbar to sacral nerve rerouting was performed. Subjects underwent urodynamic testing with stimulation of the cutaneous dermatome and careful neurological followup. Adverse events were closely monitored along with changes in bowel and bladder function.

RESULTS:

At 1 year 7 patients (78%) had a reproducible increase in bladder pressure with stimulation of the dermatome. Two patients were able to stop catheterization and all safely stopped antimuscarinics. No patient achieved complete urinary continence. The majority of subjects reported improved bowel function. One patient was continent of stool at baseline and 4 were continent at 1 year. Of the patients 89% had variable weakness of lower extremity muscle groups at 1 month. One child had persistent foot drop and the remainder returned to baseline by 12 months.

CONCLUSIONS:

At 1 year a novel reflex arc with stimulation of the appropriate dermatome was seen in the majority of subjects. Improvements in voiding and bowel function were noted. Lower extremity weakness was mostly self-limited, except in 1 subject with a persistent foot drop. More patients and longer followup are needed to assess the risk/benefit ratio of this novel procedure.

另外,我还搜到了一些editorial comment和引用了此研究结果的review,以及较早的肖传国教授以自己为第一作者发表的肖氏手术的论文(1999,2003,2005年)。

与肖医生公布的3年随访研究遥相呼应一下,呵呵~~~



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