PDF(Pubmed)
Abstract：
UNASSIGNED: Diabetic neurogenic bladder (DNB) is one of the autonomic neuropathies of diabetes mellitus (DM), with an incidence rate reaching 40-60%. This study combined bladder function rehabilitation training and mecobalamin to treat a patient with DNB to provide reference for clinical work.
UNASSIGNED: A 67-year-old woman was admitted to our hospital on 5 December 2018, with a 3-year history of dysuria that had progressively worsened for 15 days. The patient was treated with pelvic floor myofascial manipulation combined with Kegel training and mecobalamin for 6 months. Pelvic organ prolapse (POP), pelvic floor surface electromyography (EMG), psychological status, and quality of life were evaluated before, during, and after treatment, and the changes in urodynamics were observed. After comprehensive rehabilitation treatment, the patient\'s POP, pelvic floor muscle strength, mental state, and quality of life were significantly improved. The results of the urodynamic examination showed that the patient\'s safe bladder capacity reached 500 mL after treatment, in contrast to the first safe bladder capacity measurement of 90 mL. The symptoms of ureteral reflux disappeared, the detrusor compliance increased from 2 to 20 mL/cmH2O, which roughly indicated a return to healthy function. However, there was no detrusor contraction in the bladder during urination.
UNASSIGNED: This patient achieved good curative effect after the treatment of comprehensive pelvic floor rehabilitation combined with mecobalamin. However, the safe capacity of the patient reported in this case showed a small bladder safe capacity, and the patient\'s detrusor muscle did not contract during urination. Thus, urination in this patient may be accomplished by increasing abdominal pressure. When treating patients with atypical neurogenic bladder, the adverse effects caused by excessive abdominal pressure and abdominal wall relaxation need to be considered.
UNASSIGNED: A 67-year-old woman was admitted to our hospital on 5 December 2018, with a 3-year history of dysuria that had progressively worsened for 15 days. The patient was treated with pelvic floor myofascial manipulation combined with Kegel training and mecobalamin for 6 months. Pelvic organ prolapse (POP), pelvic floor surface electromyography (EMG), psychological status, and quality of life were evaluated before, during, and after treatment, and the changes in urodynamics were observed. After comprehensive rehabilitation treatment, the patient\'s POP, pelvic floor muscle strength, mental state, and quality of life were significantly improved. The results of the urodynamic examination showed that the patient\'s safe bladder capacity reached 500 mL after treatment, in contrast to the first safe bladder capacity measurement of 90 mL. The symptoms of ureteral reflux disappeared, the detrusor compliance increased from 2 to 20 mL/cmH2O, which roughly indicated a return to healthy function. However, there was no detrusor contraction in the bladder during urination.
UNASSIGNED: This patient achieved good curative effect after the treatment of comprehensive pelvic floor rehabilitation combined with mecobalamin. However, the safe capacity of the patient reported in this case showed a small bladder safe capacity, and the patient\'s detrusor muscle did not contract during urination. Thus, urination in this patient may be accomplished by increasing abdominal pressure. When treating patients with atypical neurogenic bladder, the adverse effects caused by excessive abdominal pressure and abdominal wall relaxation need to be considered.
摘要：
未经证实：糖尿病神经源性膀胱（DNB）是糖尿病（DM）的自主神经病变之一，发病率达到40-60%。本研究结合膀胱功能康复训练和甲钴胺治疗1例DNB患者,为临床工作提供参考。
UNASSIGNED：一名67岁妇女于2018年12月5日入院，有3年的排尿困难病史，并逐渐恶化15天。患者采用盆底肌筋膜手法结合Kegel训练和甲钴胺治疗6个月。盆腔器官脱垂(POP),盆底表面肌电图(EMG),心理状态,之前评估了生活质量，during,治疗后,观察尿动力学的变化。经过综合康复治疗,病人的POP,盆底肌肉力量,精神状态,生活质量明显改善。尿动力学检查结果显示,治疗后患者的安全膀胱容量达到500mL,与90mL的首次安全膀胱容量测量相反。输尿管反流症状消失，逼尿肌顺应性从2毫升/cmH2O增加到20毫升/cmH2O，这大致表明了健康功能的回归。然而,排尿期间膀胱中没有逼尿肌收缩。
UNASSIGNED：该患者经盆底综合康复联合甲钴胺治疗后取得了良好的疗效。然而,在这种情况下报告的患者的安全容量显示膀胱安全容量较小，患者的逼尿肌在排尿时没有收缩。因此，该患者的排尿可以通过增加腹压来完成。在治疗非典型神经源性膀胱患者时，腹压过高和腹壁松弛引起的不良影响需要考虑。
UNASSIGNED：一名67岁妇女于2018年12月5日入院，有3年的排尿困难病史，并逐渐恶化15天。患者采用盆底肌筋膜手法结合Kegel训练和甲钴胺治疗6个月。盆腔器官脱垂(POP),盆底表面肌电图(EMG),心理状态,之前评估了生活质量，during,治疗后,观察尿动力学的变化。经过综合康复治疗,病人的POP,盆底肌肉力量,精神状态,生活质量明显改善。尿动力学检查结果显示,治疗后患者的安全膀胱容量达到500mL,与90mL的首次安全膀胱容量测量相反。输尿管反流症状消失，逼尿肌顺应性从2毫升/cmH2O增加到20毫升/cmH2O，这大致表明了健康功能的回归。然而,排尿期间膀胱中没有逼尿肌收缩。
UNASSIGNED：该患者经盆底综合康复联合甲钴胺治疗后取得了良好的疗效。然而,在这种情况下报告的患者的安全容量显示膀胱安全容量较小，患者的逼尿肌在排尿时没有收缩。因此，该患者的排尿可以通过增加腹压来完成。在治疗非典型神经源性膀胱患者时，腹压过高和腹壁松弛引起的不良影响需要考虑。
