膀胱腔内电刺激结合辅助训练对神经源性膀胱活动低下患者尿流动力学的影响

The Effect of Intravesical Electrical Stimulation Combined with Auxiliary Training on Urodynamic in Patients with Neurogenic Underactive Bladder

目的:探讨膀胱腔内电刺激(IVES)结合辅助训练对神经源性膀胱活动低下(NUB)患者尿流动力学的影响。方法:选取2020年5月—2021年6月兴国县中医院收治的66例NUB患者作为本次研究对象,通过随机数字表法将其分为两组,各33例。对照组采用间歇性清洁导尿和膀胱功能辅助训练,观察组则给予IVES结合膀胱功能辅助训练。比较两组治疗前后的排尿日记,对两组治疗前后尿流动力学指标(最大尿流率、最大膀胱容量、最大尿流率时膀胱压、残余尿量)进行比较,评估两组下尿路症状(LUTS)、生活质量及并发症发生率。结果:与对照组相比,治疗后观察组单次排尿量明显更高,排尿次数和尿失禁次数均更低(P<0.05);治疗后两组尿流动力学指标均有所改善,观察组最大尿流率、最大膀胱容量、最大尿流率时膀胱压均明显高于对照组,残余尿量少于对照组(P<0.05);与对照组相比,治疗后观察组尿失禁生活质量问卷(I-QOL)评分明显更高,LUTS评分更低(P<0.05);观察组并发症总发生率为6.06%,明显低于对照组的24.24%(P<0.05)。结论:IVES结合辅助训练应用于NUB患者的治疗中,有利于改善患者排尿功能和尿流动力学指标,同时能有效提高其生活质量,降低并发症发生率。

Objective:To investigate the effect of intravesical electrical stimulation(IVES)combined with auxiliary training on urodynamic in patients with neurogenic underactive bladder(NUB).Method:A total of 66 NUB patients admitted to Xingguo Hospital of Traditional Chinese Medicine from May 2020 to June 2021 were selected as the objects of this study,and were divided into two groups according to random number table method,with 33 cases in each group.The control group received clean intermittent catheterization and bladder function auxiliary training,and the observation group received IVES combined with bladder function auxiliary training.The voiding diary between the two groups were compared before and after treatment.Urodynamic indexes(maximum flow rate,maximal bladder capacity,bladder pressure at maximum urine flow,residual urine volume)were compared between the two groups before and after treatment.Lower urinary tract symptoms(LUTS),quality of life and complication rate in both groups were evaluated.Result:Compared with the control group,after treatment,the single urination volume in the observation group was significantly higher,the times of urination and urinary incontinence were lower(P<0.05).After treatment,the urodynamic indexes of both groups were improved,the maximum flow rate,maximal bladder capacity and bladder pressure at maximum urine flow of the observation group were significantly higher than those of the control group,and the residual urine volume of the observation group was lower than that of the control group(P<0.05).Compared with the control group,after treatment,incontinence quality of life questionnaire(I-QOL)score in observation group was significantly higher and LUTS score in observation group was lower(P<0.05).The incidence of complications in the observation group was 6.06%,which was significantly lower than 24.24%in the control group(P<0.05).Conclusion:IVES combined with auxiliary training in the treatment of NUB patients is beneficial to improve patients'urination function and urodynamic indexes,and can effectively improve their quality of life and reduce the incidence of complications.