足三里注射甲硫酸新斯的明对脊髓损伤后尿潴留患者膀胱功能及生活质量的影响

Effects of Injection of Neostigmine Methylsulfate at Zusanli on Bladder Function and Quality of Life in Patients with Uroschesis after Spinal Cord Injury

目的:探讨足三里注射甲硫酸新斯的明对脊髓损伤后膀胱尿潴留患者膀胱功能及生活质量的影响。方法:选取新余市中医院康复科2018年12月—2021年12月收治的80例脊髓损伤后神经源性膀胱尿潴留患者为研究对象,按随机数字表法分为对照组与观察组,各40例。对照组采用间歇性导尿+膀胱功能训练+肌肉注射甲硫酸新斯的明,观察组采用间歇性导尿+膀胱功能训练+足三里注射甲硫酸新斯的明。比较两组尿流动力学及膀胱功能指标、排尿功能、世界卫生组织生存质量测定量表(WHOQOL-BREF)评分及不良反应发生情况。结果:治疗后,两组膀胱安全容量、最大逼尿肌压力、平均尿流率、最大尿流率及膀胱顺应性水平均较治疗前升高,且观察组均高于对照组,膀胱残余尿量均较治疗前降低,且观察组低于对照组,差异均有统计学意义(P<0.05)。治疗后,两组排尿功能均优于治疗前,且观察组优于对照组,差异均有统计学意义(P<0.05)。治疗后,两组WHOQOL-BREF评分均升高,且观察组WHOQOL-BREF评分高于对照组,差异均有统计学意义(P<0.05)。两组治疗期间均未发生肝肾损伤,且不良反应发生率比较,差异无统计学意义(P>0.05)。结论:足三里注射甲硫酸新斯的明可明显改善脊髓损伤后神经源性膀胱尿潴留患者尿流动力学和膀胱功能,提高其生活质量,且安全性值得肯定。

Objective:To explore the effects of injection of Neostigmine Methylsulfate at Zusanli on bladder function and quality of life in patients with bladder uroschesis after spinal cord injury.Method:A total of 80 patients with neurogenic bladder uroschesis after spinal cord injury admitted to the Rehabilitation Department of Xinyu Hospital of Traditional Chinese Medicine from December 2018 to December 2021 were selected as the study objects,and they were divided into control group and observation group according to random number table method,with 40 cases in each group.The control group was treated with intermittent catheterization+bladder function training+intramuscular injection of Neostigmine Methylsulfate,and the observation group was treated with intermittent catheterization+bladder function training+injection of Neostigmine Methylsulfate at Zusanli.Urodynamics,bladder function,urination function,WHO quality of life-BREF(WHOQOL-BREF)score and adverse reactions were compared between the two groups.Result:After treatment,the safe bladder volume,maximal detrusor pressure,average flow rate,maximum flow rate and bladder compliance level in both groups were higher than those before treatment,and those in the observation group were higher than those in the control group,the residual bladder volume were lower than those before treatment,and that in the observation group was lower than that in the control group,the differences were statistically significant(P<0.05).After treatment,the urination function of both groups were better than those before treatment,and that of observation group was better than that of control group,the differences were statistically significant(P<0.05).After treatment,WHOQOL-BREF scores of both groups increased,and WHOQOL-BREF score of observation group was higher than that of control group,the differences were statistically significant(P<0.05).There was no liver or kidney injury between the two groups during treatment,and there was no significant difference in the incidence of adverse reactions(P>0.05).Conclusion:Injection of Neostigmine Methylsulfate at Zusanli can significantly improve urodynamics and bladder function in patients with neurogenic bladder uroschesis after spinal cord injury,and improve their quality of life,and the safety is worthy of evaluation.