电针治疗宫颈癌根治术后膀胱功能障碍的机制研究

Clinical research of electric acupuncture in the treatment of bladder dysfunction after radical hysterectomy

目的探讨电针治疗子宫颈癌术后膀胱功能障碍的临床效果和可能机制。方法回顾性分析两家医院2009年1月至2012年12月子宫颈癌术后患者120例，其中电针治疗组56例、常规治疗组64例，观察术后2周自主排尿成功率、术后2周尿动力学检测指标和术后膀胱功能障碍类别。结果电针治疗组和常规治疗组术后2周自主排尿成功率分别为83．93％（47／56）和70．97％（44／62），两者比较无统计学差异（P=0．057）。电针治疗组术后2周膀胱顺应性高于常规治疗组，有统计学差异（P=0．046），两组术后2周膀胱初感容积、最大膀胱容量、最大尿流率、最大尿流率时逼尿肌压力均无统计学差异（P〉0．05）。电针治疗组术后2周低顺应性膀胱和逼尿肌收缩力受损发生率均低于常规治疗组，有统计学差异（P=0．049，0．038），两组术后2周逼尿肌过度活动、膀胱流出道梗阻和逼尿肌外括约肌协同失调发生率均无统计学差异（P〉0．05）。结论电针可以降低子宫颈癌术后2周膀胱功能障碍的发生风险，机制可能为提高膀胱顺应性和减轻逼尿肌收缩力受损。

Objective To investigate effect and mechanism of electric acupuncture in the treatment of bladder dysfunction after radical hysterectomy. Methods These was a multi-center, retrospective study. 120 cases of bladder dysfunction after radical hysterectomy were enrolled from January 2009 to December 2012 [56 cases in electric acupuncture group （EA group）, 64 cases in control group]. The success rate of automatic micturition and urinary dynamic detection indexes at 2 weeks after operation, classification of bladder dysfunction were investigated. Results The success rate of automatic micturition at 2 weeks after operation in EA group and control group were 83.93% （47/56） and 70.97% （44/62） respectively, without statistically significant difference between two groups （P = 0.057）. There were statistically significant differences in bladder compliance, the incidences of bladder low compliance and bladder detrusor dysfunction at 2 weeks after operation between two groups （P = 0.046, 0.049, 0.038）. Conclusion Electric acupuncture can reduce risk of bladder dysfunction. Mechanism may be improving bladder compliance and bladder detrusor dysfunction.