磁刺激初级运动皮层(M1区)对不完全性脊髓损伤患者膀胱功能的影响

Effect of magnetic stimulation of primary motor cortex(M1) on bladder function in patients with incomplete spinal cord injury

目的:探讨磁刺激初级运动皮层(M1区)对不完全性脊髓损伤患者膀胱功能的影响。方法:60例不完全性脊髓损伤后神经源性膀胱患者随机分为试验组、假刺激组、对照组,分别进行4周治疗。试验组在常规治疗基础上给予M1区磁刺激;假刺激组方法同试验组,但无磁刺激输出;对照组给予常规治疗。治疗前后比较3组患者的排尿日记、尿动力学指标、Qualiveen量表评分。结果:3组患者各项指标均值(残余尿量、日均单次排尿量、膀胱顺应性、最大尿流率、最大膀胱容量、Qualiveen量表评分)在治疗后均有不同程度的改善且有统计学差异(P<0.05),试验组各项指标较假刺激组和对照组差异有统计学意义(P<0.05)。结论:磁刺激初级运动皮层可改善不完全性脊髓损伤患者膀胱功能。

Objective:To investigate the effect of magnetic stimulation of the primary motor cortex(M1)on bladder function in patients with incomplete spinal cord injury(SCI). Methods:A total of 60 SCI patients with neurogenic bladder were randomly divided into experimental group,sham stimulation group,and control group. The patients in the experimental group were given conventional treatment combined with magnetic stimulation of M1,those in the sham stimulation group were given the same treatment as the experimental group without magnetic stimulation,and those in the control group were given conventional treatment alone. The three groups were compared in terms of voiding diary,urodynamic parameters,and Qualiveen score before and after treatment. Results:All three groups had significant improvements in residual urine volume,daily single voided volume,bladder compliance,maximum urinary flow rate,maximum bladder capacity,and Qualiveen score after treatment(P<0.05),and there were significant differences in these indices between the experimental group and the other two groups(P<0.05). Conclusion:Magnetic stimulation of primary motor cortex can improve bladder function in patients with incomplete SCI.