骶神经磁刺激预防宫颈癌术后尿潴留的效果

Effect of sacral magnetic stimulation on prevention of urinary retention after cervical cancer surgery

目的探讨骶神经磁刺激预防宫颈癌术后尿潴留的临床效果。方法选取2022年3月至12月在江苏省徐州市中心医院接受广泛性子宫切除术的患者108例,采用随机数字表法将其分为对照组、电刺激组和磁刺激组,每组36例。三组均给予常规护理,术后第8天,对照组进行盆底肌训练,电刺激组在盆底肌训练的基础上应用低频电刺激10 d,磁刺激组在盆底肌训练的基础上采用骶神经磁刺激10 d。记录三组残余尿量、尿潴留发生率、尿路感染率,比较两组干预前后的盆底肌力、最大尿流率、平均尿流率、排尿量、排尿时间。记录两组干预过程中并发症发生情况,术后随访3个月,比较两组盆底功能障碍问卷及生活质量问卷评分,观察两组复发和转移情况。结果研究过程中对照组脱落1例,共35例患者完成研究。磁刺激组残余尿量、尿潴留发生率均低于对照组、电刺激组,差异有统计学意义(P<0.05)。干预后,三组盆底肌力、最大尿流率、平均尿流率、排尿量均高于干预前,且磁刺激组高于对照组和电刺激组,差异有统计学意义(P<0.05)。干预后,三组排尿时间均短于干预前,且磁刺激组短于对照组和电刺激组,差异有统计学意义(P<0.05)。磁刺激组盆底障碍影响问卷、盆底功能障碍问卷评分低于对照组和电刺激组,差异有统计学意义(P<0.05)。三组干预期间均无并发症发生,且随访期间复查均无复发及转移征象。结论骶神经磁刺激对宫颈癌术后尿潴留的预防效果显著,可降低残余尿量,改善排尿困难,提高患者盆底肌力,提升患者的生活质量。

Objective To investigate the clinical effect of sacral magnetic stimulation on prevention of urinary retention after cervical cancer surgery.Methods A total of 108 patients who underwent radical hysterectomy in Xuzhou Central Hospital,Jiangsu Province from March to December 2022 were selected and divided into control group,electrical stimulation group,and magnetic stimulation group by random number table method,with 36 cases in each group.The three groups were given routine care.On the 8th day after surgery,pelvic floor muscle training was performed in the control group,low-frequency electrical stimulation was applied on the basis of pelvic floor muscle training for ten days in the electrical stimulation group,and sacral magnetic stimulation was applied on the basis of pelvic floor muscle training for ten days in the magnetic stimulation group.The residual urine volume,incidence of urinary retention,and urinary tract infection rate of the three groups were recorded,and the pelvic floor muscle strength,maximum urine flow rate,average urine flow rate,urinary volume,and urinary time of the two groups were compared before and after intervention.The occurrence of complications during the intervention was recorded in the two groups.After three months’follow-up,the scores of pelvic floor dysfunction questionnaire and quality of life questionnaire were compared between the two groups,and the recurrence and metastasis of the two groups were observed.Results During the study,one case fell off in the control group,and a total of 35 patients completed the study.The residual urine volume and the incidence of urinary retention in the magnetic stimulation group were lower than those in the control group and the electrical stimulation group,and the differences were statistically significant(P<0.05).After intervention,the pelvic floor muscle strength,maximum urine flow rate,average urine flow rate,and urinary volume of the three groups were higher than before intervention,and those of magnetic stimulation group were higher than those of control group and the electrical stimulation group,the differences were statistically significant(P<0.05).After intervention,the urination time of the three groups were shorter than those before intervention,and those of magnetic stimulation group were shorter than those of control group and the electrical stimulation group,the differences were statistically significant(P<0.05).The scores of the pelvic floor dysfunction questionnaire and the pelvic floor dysfunction questionnaire in the magnetic stimulation group were lower than those in the control group and the electrical stimulation group,the differences were statistically significant(P<0.05).No complications occurred in the three groups during the intervention period,and there were no signs of recurrence and metastasis during follow-up.Conclusion Sacral magnetic stimulation has a significant effect on the prevention of urinary retention after cervical cancer surgery,which can reduce residual urine volume,improve urinary dysuria,improve pelvic floor muscle strength,and improve the quality of life of patients.