电针结合膀胱功能训练对胸腰段爆裂骨折伴低张力型膀胱患者排尿功能的影响

Effect of electroacupuncture combined with bladder control training on urinary function in patients after thoracolumber fracture with hypotonic bladder

目的探讨电针结合膀胱功能训练对胸腰段爆裂骨折伴低张力型膀胱患者排尿功能的影响。方法回顾性分析自2016年3月~2018年3月西安交通大学附属红会医院诊治的胸腰段爆裂骨折伴低张力型膀胱患者43例,根据治疗方式分为治疗组(n=22)与对照组(n=21)。治疗组采用电针结合膀胱功能训练治疗,对照组采用电针治疗,共治疗8周,评价其临床效果。比较两组膀胱容量、残余尿量、排尿次数及生活质量核心量表(QOL-C30)评分变化。结果治疗8周后,治疗组总有效率高于对照组,差异有统计学意义(P <0.05)。治疗组残余尿量减少率高于对照组,自主及辅助排尿增加率高于对照组,差异有统计学意义(均P <0.05)。治疗前,两组每次排尿量、最大排尿量、最大膀胱容量、膀胱排尿压力比较,差异无统计学意义(P> 0.05)。治疗后两组每次排尿量、最大排尿量、最大膀胱容量、膀胱排尿压力高于治疗前,且治疗组高于对照组,差异均有统计学意义(均P <0.05)。治疗前躯体症状、社会症状、心理症状、物质症状评分比较,差异无统计学意义(P> 0.05)。治疗8周后,两组躯体症状、社会症状、心理症状、物质症状评分高于治疗前,且治疗组高于对照组,差异均有统计学意义(均P <0.05)。结论电针结合膀胱功能训练能有效改善胸腰段爆裂骨折伴低张力型膀胱患者排尿功能,预防患者的远期并发症,提高生活质量。

Objective To investigate the effects of electroacuncture combined with bladder control training on urinary function in patients after thoracolumber fracture with hypotonic bladder. Methods From March 2016 to March 2018,43 cases with thoracolumber fracture with hypotonic bladder who treated in Honghui Hospital, Xi′an Jiaotong University were selected. They were divided into treatment group(n = 22) and control group(n = 21), according to the treatment methods. Treatment group was treated with electroacupuncture combined with bladder control training, and control group was treated with electroacupuncture. The treatment lasted for 8 weeks and clinical effect was evaluated. Bladder capacity, residual urine volume, urination frequency and quality of life questionnai-core 30(QOL-C30) scores were compared. Results After 8 weeks of treatment, the total effective rate of treatment group was higher than that of control group, and the difference was statistically significant(P < 0.05). The reduction rate of residual urine volume in treatment group was higher than that in control group, and the increase rate of the number of independent and assisted urination was higher than that in control group, with statistically significant differences(all P < 0.05). Before treatment,there was no statistically significant difference between two groups in each urination volume, maximum urination volume, maximum bladder volume and bladder urination pressure(P > 0.05). After treatment, each urinary volume, maximum urination volume, maximum bladder volume and bladder urination pressure of two groups were higher than those before treatment, and treatment group was higher than control group, with statistically significant differences(all P <0.05). There was no significant difference in scores ofsomatic symptoms, social symptoms, psychological symptoms and physical symptoms before treatment. After 8 weeks of treatment, scores of somatic symptoms, social symptoms, psychological symptoms and physical symptoms in two groups were higher than those before treatment, and treatment group was higher than control group, with statistically significant differences(all P < 0.05). Comclusion Electroacupuncture combined with bladder contol training can effectively improve urinary function in patients after thoracolumberfracture with hypotonic bladder, prevent long-term complications and improve quality of life.