盆底肌肉电刺激治疗脊髓损伤患者尿失禁的疗效观察

Effectiveness of electrical stimulation of pelvic floor muscles in the treatment of urinary incontinence in patients with incomplete spinal cord injury

目的观察盆底肌肉电刺激对脊髓损伤后尿失禁患者的治疗效果。方法本研究共选取7例不完全性脊髓损伤尿失禁患者,其中男5例,女2例;平均年龄32.5岁;脊髓损伤时间平均为7.5个月。治疗时将盆底肌肉电刺激器插入患者直肠(男性)或阴道(女性)内进行电刺激,电刺激强度以患者最大耐受能力为度,每次治疗30～45min,每天治疗1次,每周治疗5d,连续治疗2～3个月;并于治疗过程中观察患者拔尿管成功率及尿管拔除后的排尿次数和尿量等。结果治疗前,本组患者全部留置导尿管,经2～3周治疗后,均可成功拔除导尿管,经8周治疗后,有5例患者每日自排尿次数大于自流尿次数,但其总尿量无明显改变。结论电刺激盆底肌对脊髓损伤后患者的膀胱调控功能具有良好的改善作用,值得临床推广、应用。

Objective To observe the therapeutic effects of electrical stimulation of pelvic floor muscles on urinary incontinence (UI) in patients with incomplete spinal cord injury (ISCI). Methods Seven patients (5 males and 2 females; average age: 32.5 years; average duration after injury: 7.5 months) with ISCI were treated with ESPFM applied on rectum (for male) or vagina (for female) for 30～45 min,once a day, 5 days a week for (2～3) months. The rate of success on stopping using catheters and the frequency and amount of urination were observed during treatment. Results Catheters were taken out successfully from all patients 2～3 weeks after treatment. Five out of the 7 patients had more self-control of urination than incontinence after 8 weeks of treatment though there was no significant difference in the amount of the urination. Conclusion ESPFM might improve the function of urinary bladder in patients with incomplete spinal cord injury.