电刺激治疗脊髓损伤后神经源性膀胱的研究新进展

Latest research progress in the study of electrical stimulation for the treatment of neurogenic bladder after spinal cord injury

神经源性膀胱(neurogenic bladder,NB)是指由于神经系统病变引发的下尿路功能障碍(lower urinary tract dysfunction,LUTD),患者表现为一系列下尿路症状(lower urinary tract syndrome,LUTS),NB也是脊髓损伤(spinal cord injury,SCI)后常见的严重并发症,给患者生活质量和康复进程带来显著影响,甚至可导致患者死亡。因此,SCI后NB的研究也是重点与难点。当前,对于SCI后NB的治疗并没有明确有效的治疗方法,寻找安全有效的治疗方法迫在眉睫。SCI后由于神经反射通路受损,导致NB的发生,而长期反复的足疗程电刺激,可以重塑神经环路,这一观点与SCI后NB的发生机制不谋而合。电刺激治疗疾病作为一种非侵入性治疗手段,近年来显现出一定的治疗优势,是一种极具前景的治疗途径。学习近年来相关电刺激文献后对不同类型电刺激治疗SCI后NB的机制、电刺激部位、治疗效果以及安全性进行综述,以期为电刺激治疗SCI后NB提供参考。

Neurogenic bladder(NB)refers to lower urinary tract dysfunction(LUTD)caused by neurological lesion,manifesting as a series of lower urinary tract syndromes(LUTS).It is also a common serious complication after spinal cord injury(SCI),posing negative influences on the quality of life and rehabilitation,or even leading to death.Therefore,NB at post-SCI has become the research focus and challenge.Effective strategies for treating NB at post-SCI are currently not available.It is urgent to develop effective and safe treatment of it.Damage to neural reflex pathways after SCI eventually causes NB.Long-term and repeated electrical stimulations can reshape neural circuit,which is consistent with the pathogenesis of NB at post-SCI.As a non-invasive treatment method,electrical stimulation has shown certain therapeutic advantages in recent years.It has become a promising therapeutic approach.Through literature review of electrical stimulation,we summarized the pathogenesi,stimulation site,therapeutic outcome,safety of NB at post-SCI by different types of electrical stimulation,aiming to provide a reference for electrical stimulation treatment of NB at post-SCI.