盆底肌电刺激法联合膀胱功能训练促进脊髓损伤后神经源性膀胱患者膀胱功能康复的作用

Effect of pelvic floor muscle stimulation combined with bladder function training on bladder function recovery in patients with neurogenic bladder after spinal cord injury

目的探讨盆底肌电刺激法联合膀胱功能训练促进脊髓损伤后神经源性膀胱患者膀胱功能康复的作用。方法选取2015年1月~2018年12月康复治疗部治疗脊髓损伤后神经源性膀胱患者84例,采用抛硬币法分为联合组与对照组各42例。对照组患者予以膀胱功能训练,观察组在对照组基础上加盆底肌电刺激法,两组均干预8周。观察两组治疗前后最大排尿量、最大尿流率及残余尿量,并比较两组患者膀胱功能的恢复情况。结果治疗8周后,两组患者最大排尿量及最大尿流率较前明显上升,残余尿量较前显著下降,差异有统计学意义(P<0.05),且联合组患者上升或下降幅度较对照组更显著(P<0.05);同时联合组患者膀胱功能恢复情况(95.24%)明显好于对照组(80.95%),差异有统计学意义(χ^2=4.09,P<0.05)。结论盆底肌电刺激法联合膀胱功能训练用于脊髓损伤后神经源性膀胱患者的临床效果确切,能明显改善膀胱排尿的功能,减少残余尿量。

Objective To investigate the effect of pelvic floor muscle stimulation combined with bladder function training on bladder function recovery in patients with neurogenic bladder after spinal cord injury.Methods 84 patients with neurogenic bladder after spinal cord injury from January 2015 to December 2018 in rehabilitation deparment were selected,and were divided into the combined group(42 cases)and the control group(42 cases)by coin toss method.The patients in the control group underwent bladder function training.The observation group was treated with pelvic floor muscle stimulation on the basis of the treatment in the control group.Both groups were treated for 8 weeks.The maximum urine output,maximum urinary flow rate and residual urine volume before and after treatment were observed,and the recovery of bladder function was compared.Results After 8 weeks of treatment,the maximum urinary output and maximum urinary flow rate of the two groups were significantly higher than those before,and the residual urine volume was significantly lower than that before(P<0.05 or P<0.01),and the increase or decrease of the combined group was higher than that of the control group(P<0.05).The recovery of bladder function was significantly higher in the combined group(95.24%)than that in the control group(80.95%),the difference was significant(χ^2=4.09,P<0.05).Conclusion The pelvic floor muscle stimulation combined with bladder function training is effective in patients with neurogenic bladder after spinal cord injury.It can improve the function of bladder urination and reduce residual urine volume.