骶神经磁刺激联合托特罗定治疗老年女性混合性尿失禁的疗效观察

Observation of the efficacy of sacral neuromagnetic stimulation combined with totrodine in the treatment of mixed urinary incontinence in elderly women

目的探讨骶神经磁刺激联合托特罗定治疗老年女性混合性尿失禁的临床疗效。方法选取61例老年女性混合性尿失禁病人,根据就诊顺序分为对照组和观察组,对照组(n=30)服用酒石酸托特罗定缓释片(4 mg/粒,1粒/d),共服用2个月;观察组(n=31)在托特罗定基础上联合骶神经磁刺激治疗(2次/周,40 min/次),共治疗2个月。记录2组病人治疗前及治疗1、2个月时的尿失禁问卷(ICI-Q-SF)、尿失禁生活质量(I-QOL)、尿失禁程度目视量表(VAS)、膀胱过度活动症(OABSS)、盆底肌力评估评分(Glazer)及残余尿量,并对治疗2个月后2组病人临床疗效进行评价。结果2组病人治疗2个月后,ICI-Q-SF、I-QOL、尿失禁程度VAS、OABSS、Glazer评分均较治疗前有明显改善(P<0.05),对照组残余尿量较治疗前有所增加(P<0.05);与对照组比较,观察组在各时间点各项指标均较对照组改善更加明显(P<0.05)。治疗2个月后,2组总有效率分别为87.10%(27/31)、56.67%(17/30),差异有统计学意义(P<0.05)。结论骶神经磁刺激联合托特罗定药物治疗能够有效改善老年女性混合性尿失禁的临床症状,提高病人的生活质量,具有起效快、非侵袭性、同时减少药物并发症等优势,值得临床推广应用。

Objective To investigate the clinical effect of sacral neuromagnetic stimulation combined with totrodine in the treatment of mixed urinary incontinence in the elderly women.Methods A total of 61 elderly female patients with mixed urinary incontinence were randomly divided into control group and observation group according to the registration order.The control group(n=30)was given toterodine tartrate sustained release tablets for 2 months.The observation group(n=31)received toterodine combined with sacral neuromagnetic stimulation for 2 months.The questionnaire for urinary incontinence(ICI-Q-SF),quality of life for urinary incontinence(I-QOL),visual analogue scale(VAS)for urinary incontinence,bladder hyperactivity disorder(OABSS),pelvic floor strength assessment score(Glazer)and residual urine volume were recorded before treatment,1 and 2 months after treatment.The clinical efficacy of the two groups was evaluated 2 months later.Results After 2 months of treatment,the scores of ICI-Q-SF,I-QOL,VAS,OABSS and pelvic floor muscle strength in the two groups were significantly improved compared with those before treatment(P<0.05).The residual urine volume in the control group was increased compared with that before treatment(P<0.05).Compared with the control group,the indicators in the observation group at each time point were improved more significantly than those in the control group(P<0.05).After 2 months of treatment,the total effective rate of observation group and treatment group was 87.10%(27/31)and 56.67%(17/30)respectively,with statistically significant difference(P<0.05).Conclusions Sacral neuromagnetic stimulation combined with tortrodine can effectively improve the clinical symptoms of mixed urinary incontinence in the elderly women and improve the quality of life.It has the advantages of quick onset,non-invasiveness,and less drug complications,which is worthy of clinical application.