体表电刺激对自主性膀胱排尿功能的影响

Effects of Surface Electrical Stimulation on Urination Function of Autonomic Bladder

目的观察体表电刺激联合膀胱功能训练对S2-4脊髓损伤或马尾、盆神经损伤后自主性膀胱患者的疗效。方法 2016年1月至2017年8月,采用真实世界研究方法将76例脊髓损伤自主性膀胱患者分为对照组(n=29)和观察组(n=47)。对照组进行常规膀胱功能训练,观察组在对照组基础上联合膀胱肌肉电刺激治疗。于治疗前、治疗3个月后分别检测两组患者排尿日记、尿流动力学指标。结果治疗后,两组24 h尿失禁次数、24 h排尿次数、残余尿量明显减少(t>3.251,P<0.01),每次排尿量显著增加(t>5.000,P<0.001),最大膀胱容量、最大尿流率增加(t>1.922,P<0.05),充盈末期逼尿肌压显著减小(t>8.302,P<0.001);观察组均优于对照组(t>1.919,P<0.05)。结论肌肉电刺激联合膀胱功能训练可进一步改善脊髓损伤自主性膀胱的排尿功能。

Objective To observe the effect of electrical stimulation combined with bladder function training on autonomic bladder patients after S2-4spinal cord injury or cauda equina and pelvic nerve injury.Methods From January,2016to August,2017,76patients with autonomic bladder after spinal cord injury were divided into control group(n=29)and observation groups(n=47)in real world study.The control group received routine bladder function training,and the observation group received bladder muscle stimulation therapy in addition.The micturition diary and urodynamic indexes were assessed before and three months after treatment.Results After treatment,the frequency of urinary incontinence and the number of micturition in24hours,and residual urine volume significantly reduced(t>3.251,P<0.01),the urine output every time significantly increased(t>5.000,P<0.001),the maximum bladder capacity and urine flow rate increased(t>1.922,P<0.05),and the detrusor pressure in the end of filling period significantly reduced(t>8.302,P<0.001).All the indexes above were better in the observation group than in the control group(t>1.919,P<0.05).Conclusion Electrical muscular stimulation combined with the bladder functional training could improve the urination function in the patients with autonomic bladder after spinal cord injury.