研究目的：探討不同脊髓損傷部位，對膀胱功能所造成的影響與變化。研究對象：自2001年1月至2002年12月期間，接受錄影尿動力學檢查之脊髓損傷患者共112名，平均年齡37.6 ± 13.8 歲，平均受傷期間為38個月。其中男性為79人，女性為33人。依損傷部位分類，頸髓損傷者有48人，胸髓損傷者有33人，腰薦髓損傷者有31人。研究結果：頸髓損傷患者的膀胱功能，42例(88%)為逼尿肌反射亢進，4例(8%)為逼尿肌無反射，44例(92%)出現逼尿肌─尿道括約肌共濟失調，符合逼尿肌─膀胱頸共濟失調者有8例(17%)，呈現膀胱低適應力有29例(60%)，另有4例合併膀胱─輸尿管逆流(8%)。胸髓損傷患者中，依次為27例(82%)逼尿肌反射亢進，6例(18%)逼尿肌無反射，26例(79%)逼尿肌─尿道括約肌共濟失調，5例(15%)逼尿肌─膀胱頸共濟失調，膀胱低適應力有17例(52%)，3例合併膀胱─輸尿管逆流(9%)。腰薦髓損傷患者中，8例(26%)為逼尿肌反射亢進，23例(74%)逼尿肌無反射，8例(26%)出現逼尿肌─尿道括約肌共濟失調，逼尿肌─膀胱頸共濟失調僅1例(3%)，膀胱低適應力16例(52%)，膀胱─輸尿管逆流有1例(3%)。結論：端視損傷部位之分佈，不足以正確推論脊髓損傷者的膀胱之功能，需配合使用錄影尿動力學檢查進行評估，才能充分顯示膀胱在解剖生理學上的變化，提供膀胱照護的重要參考。
英文摘要 To examine the relationship between the clinical neurological level, and bladder behavior, the videourodynamic studies of 122 patients with spinal cord injury were analyzed from January 2001 to December 2002. Seventy-nine patients were male 33 were female. Forty-eight patients had injuries involving the cervical cord, 33 the thoracic cord and 31 the lumbosacral cord. Patients were classified based on the clinical neurological level. Diagnoses based on urodynamic evaluations were detrusor hyperreflexia, detrusor areflexia, detrusor-external sphincter dyssynergia, detrusor-bladder neck dyssynergia, low bladder compliance or normal. The presence of vesicoureteral reflux also was recorded. Results indicated that although there was a general correlation between neurological level of injury and expected bladder function, it was neither absolute nor specific. Out data suggest that clinical neurological examination alone dose not accurately predict neurogenic bladder dysfunction and that videourodynamic evaluations provide more precise diagnoses.
