不同频率高频磁刺激治疗脊髓损伤后神经源性膀胱的临床疗效观察

Clinical observation of different frequencies of high-frequency magnetic stimulation in treatment of neurogenic bladder after spinal cord injury

目的探讨不同频率高频磁刺激治疗脊髓损伤后神经源性膀胱的临床疗效。方法选取2021年1月至2022年1月河南科技大学第一附属医院收治的90例脊髓损伤后神经源性膀胱患者作为研究对象,所有患者均行常规治疗联合高频磁刺激治疗。根据高频磁刺激治疗的频率不同将纳入对象分为低频组(n=45)和高频组(n=45)。采用磁刺激仪对S3神经根进行磁刺激治疗,低频组采用5 Hz,高频组采用15 Hz,每日治疗2次,连续治疗6 d休息1 d,7 d为1疗程,两组均治疗8个疗程。对比两组患者距首次排尿时间、距建立反射性排尿时间、平均残余尿量以及距残余尿量<100 mL时间等排尿功能指标,对比两组患者神经源性膀胱症状评分(Neurogenic Bladder Symptom Score,NBSS),对比两组患者膀胱初始尿意容量、最大膀胱容量以及残余尿量等尿流动力学指标。结果治疗后高频组距首次排尿时间、建立反射性排尿时间、平均残余尿量和距残余尿量<100 mL时间均明显低于低频组(P<0.05),治疗后高频组NBSS评分明显低于低频组(P<0.05),治疗后高频组膀胱初始尿意容量、最大膀胱容量均明显高于低频组(P<0.05),高频组残余尿量明显低于低频组,差异有统计学意义(P<0.05)。结论不同频率高频磁刺激治疗脊髓损伤后神经源性膀胱患者的疗效有差异,15 Hz频率的磁刺激有助于改善排尿功能,增加膀胱最大容量,改善尿流动力学。

【Objective】To investigate the clinical efficacy of high-frequency magnetic stimulation with different frequencies in the treatment of neurogenic bladder after spinal cord injury.【Methods】Ninety patients with neurogenic bladder after spinal cord injury were selected as the research subjects.The case selection time was from January 2021 to January 2022.All patients received conventional treatment combined with high-frequency magnetic stimulation therapy.The frequency of stimulation treatment was different,and the subjects were divided into low-frequency group and high-frequency group.The S3 nerve root was treated with magnetic stimulation by a magnetic stimulator.The low-frequency group was treated with 5 Hz,and the high-frequency group was treated with 15 Hz.The treatment was twice a day.The treatment continued for 6 days and rested for 1 day.The urination function indicators such as the time from the first urination,the time from the establishment of reflex urination,the average residual urine volume,and the time from the residual urine volume to<100 ml were compared between the two groups of patients,the Neurogenic Bladder Symptom Score(NBSS)of the two groups of patients was compared,and urodynamic indicators such as the initial bladder capacity,maximum bladder volume,and residual urine volume were compared between the two groups of patients.【Results】After treatment,the time to first voiding,the time to establish reflex voiding,the average residual urine volume and the time to residual urine volume<100 ml in the high-frequency group were significantly lower than those in the low-frequency group(P<0.05).After treatment,NBSS in the high-frequency group was significantly lower than the low-frequency group(P<0.05).After treatment,the initial bladder capacity and maximum bladder capacity in the high-frequency group were significantly higher than those in the low-frequency group(P<0.05),the residual urine volume in the high-frequency group was significantly lower than that in the low-frequency group(P<0.05),the differences were statistically significant.【Conclusion】Different frequencies of highfrequency magnetic stimulation have different curative effects in the treatment of patients with neurogenic bladder after spinal cord injury.Magnetic stimulation with a frequency of 15 Hz can help improve voiding function,increase maximum bladder capacity,and improve urodynamics.