Wang Wenjuan,Yang Shuai,Zhou Zhaokai,et al.Analysis of lower urinary tract symptoms and psychological behavior changes in children with tethered cord syndrome after tethered cord release[J].Journal of Clinical Pediatric Surgery,,22():249-253.[doi:10.3760/cma.j.cn101785-202211065-009]
Analysis of lower urinary tract symptoms and psychological behavior changes in children with tethered cord syndrome after tethered cord release
- Keywords:
- Tethered Cord Syndrome; Psychology; Lower Urinary Tract Symptoms; Surgical Procedures; Operative; Child
- Abstract:
- Objective To quantitatively evaluate the changes of lower urinary tract symptoms (LUTS) and psychological behavior in children with tethered cord syndrome (TCS) before and after tethered cord release and explore the effects of deterring surgery (DS) on LUTS and psychological behavior.Methods From January 2020 to May 2022,43 patients with TCS and DS diagnosed by MRI were retrospectively reviewed.According to the results of Lower Urinary Tract Dysfunction Research Network Symptom Index-29 (LURN SI-29) and Strengths & Difficulties Questionnaire (SDQ),patient LUTS and psychological behavior changes before and after operation were quantitatively evaluated.Results 43 patients (operating age 9.19±2.61 years) completed follow-up,with an average follow-up time of(9.12±6.54)months. The paired rank sum test of LURN SI-29 before and after DS showed that postoperative urinary incontinence [25.02(4.17,66.72 )vs.12.51(0.00, 37.53)],dysuria [0.00(0.00,35.00)vs.0.00(0.00,30.00)],urgency of urination [0.00 (0.00,24.99)vs.0.00(0.00,24.99)],and total score of LURN SI-29 [24.75(15.23,41.88)vs.17.14(12.38,31.41)] were significantly lower than those before operation(P<0.05); Postoperative residual urine decreased significantly[20(7.5,50.3)ml vs.11(3.0,30.0)ml],the difference was significant(P<0.05); Comparing the detection rates of psychological behavioral abnormalities before and after surgery,emotional problems [20(46.5%)vs.21(48.8%)],conduct problems [10(23.3%)vs.11(25.6%)],hyperactivity-inattention [14(32.6%)vs.10(23.3%)],peer interaction problems [19(44.2%)vs.15(34.9%)],prosocial behavior [5(11.6%)vs. 2(4.7%)],and total SDQ difficulty scores [13(30.2%)vs.10(23.3%)] were not statistically significant (P>0.05).Conclusion DS may improve LUTS.However,it cannot modify the impact of TCS on psychological behavior in children.For TCS children,nursing psychological counseling and health education should be strengthened along with DS.
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Memo
收稿日期:2022-11-30。
基金项目:国家自然科学基金(U1904208);河南省医学科技攻关计划省部共建项目(SBGJ2018059)
通讯作者:杨静,Email:femaleurology@126.com