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Rehabilitation Practice and Science

Translated Title

男性脊髓損傷患者長期腎功能之追蹤

Abstract

The purpose of this study is to discuss the long term changes of renal function in traumatic spinal cord injured patients. This study was carried out on 45 male cases who suffered from complete traumatic spinal cord injury. As a result of injury 17 cases were quadriplegic, 28 were paraplegic. The mean age of these cases was 41.5 years (range from 21 to 60 years). The mean period of these cases since onset to receiving urodynamic study was 2 years and 4 months (range from 1 month to 14 years). All of these cases had accepted at least two urodynamic studies with interval longer than 1 year. Meanwhile, every case had been followed by urine analysis and culture, intravenous renography, voiding cystourethrography, cystometry with sphincter EMG and 24 hours creatinine clearance (Ccr). There were also 19 cases followed by renal scan and 35 cases by cystoscopic examination.If Ccr is taken as a parameter of renal function, the results would reveal that the preservation of good renal function depends on the following 3 conditions: (1) successfully ICP trained cases got better result than untrained or failed cases (75±21 vs 56±27, p＜0.05). (2) paraplegic cases got better result than quadriplegic cases (77±27 vs 60±21, p＜0.05). (3) lower motor neuron type neurogenic bladder got better result than upper type (79±28 vs 60±21, p＜0.05).Considering the cost of ICP training, the average cost for each trained case is 33,000 NT dollars. Comparing with the expensive spending for treating complications due to unbalanced neurogenic bladder, it is necessary to accept ICP training. However, as a patient with upper motor neuron type neurogenic bladder, he must continue to monitor his renal function carefully because of the relatively high incidence of detrusor-sphincter dyssynergia. Though the Ccr test is not as sensitive as renal scan for detecting renal function, is still can become an economic and effective test for long term follow-up of renal function by modifying its collecting method.

Language

Traditional Chinese

First Page

9

Last Page

16

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