2026-11-092026-11-09https://scholars.csmu.edu.tw/handle/123456789/38552Urologic complications have been the major source of morbidity and mortality among patients with spinal cord injury (SCI). Improvements in urologic care may be credited for the improved survival among SCI persons. Injury to the spinal cord occurs above the conus medullaris, detrusor hyperreflexia with the detrusor-sphincter dyssynergia, and impaired compliance commonly develops. Injury directly to either the conus medullaris or cauda equina usually results in detrusor areflexia, and a poorly compliant bladder. Several studies have correlated low bladder compliance with upper urinary tract complications and decreased renal function in SCI population. The measurement of bladder compliance heavily based on the individual criteria of selection and urodynamic findings. There was no standard method of interpretation to meet all the studies yet. The correlation of low compliance with urologic complications and clinical characters, such as the level of lesion and completeness of injury, were variable in different studies. We conduct this study to analyze these results in order to establish the clinical standard of bladder compliance, and follow-up the alternation in bladder compliance in a cohort of newly injured subjects with SCI.上尿路病變及腎功能受損經常造成脊髓損傷者死亡及罹病，近年因為 膀胱照護觀念與技術的進步，加上長期監測尿路功能，使得腎臟疾病的發 生已明顯降低。因此定期接受泌尿功能評估，可以協助脊髓損傷者維護腎 臟與尿路功能。 臨床發現，脊髓損傷後導致膀胱與尿道括約肌功能的改變，包括：出 現膀胱逼尿肌反射性收縮過強，合併逼尿肌–尿道括約肌共濟失調，膀胱 適應力降低(low bladder compliance)等，均易造成膀胱內壓上升，排尿阻力 增加。有研究顯示，約有10％薦髓以上部位損傷的患者與50％薦髓部位損 傷的患者，表現出膀胱適應力降低；但膀胱適應力的評估，會受到研究者 設定的判讀條件及尿動力學參數影響而各有差異，所以目前沒有一定的計 算方式。而且患者膀胱適應力的長期變化，亦無研究進行追蹤與探討。 因此，本研究以受傷三個月之內的早期脊髓損傷者為對象，進行世代 族群研究，以錄影尿動力學檢查，配合膀胱錄影影像之解剖變化，記錄膀 胱壓力與膀胱容量瞬時對應的數據，以探查記錄患者膀胱適應力變化與臨 床參數的相關性；並以正常成年人的膀胱適應力為校正值，據此建立標準 量化的膀胱適應力分析與計算，作為臨床上的應用參考。並追蹤此群患者 的膀胱適應力的改變，以探討脊髓損傷患者膀胱適應力之長期變化，同時 探討與其他臨床參數之相關性。神經性膀胱膀胱適應力脊髓損傷neurogenic bladderbladder compliancespinal cord injuryProject