盆底肌电刺激法与膀胱训练法.PDFVIP

浙江医学2017 年第39 卷第4 期 盆底肌电刺激法与膀胱训练法 治疗不完全脊髓损伤术后排尿 障碍的比较研究 刘良乐 戴鸣海 刘敏 汤呈宣 何少奇 钟熙强 【摘要 】 目的 比较盆底肌电刺激法与膀胱训练法治疗不完全脊髓损伤术后患者排尿功能障碍的疗效。方法 选取不完全 脊髓损伤术后患者73 例，采用随机数字表法分为治疗组35 例和对照组38 例。治疗组采用盆底肌电刺激法；对照组采用膀胱训练法， 并控制饮水量。比较两组患者治疗前后膀胱残余尿量（RUV ）、最大膀胱容量（MBC ）、最大尿流率（MFR ）、平均尿流率（AFR ）、充盈期末 逼尿肌压力（PdetQmax ）及治疗后拔除尿管成功率、留置导尿管天数和尿路感染发生率。结果 治疗组拔除尿管成功率为94.3% ，明 显高于对照组的73.7% ，差异有统计学意义（P 0.05 ）。与治疗前比较，两组患者治疗后的MBC、MFR 和AFR 均有所增加，RUV 减少， PDetQmax 下降，差异均有统计学意义（均P 0.05 ）。随访终末期，治疗组各项尿流动力学指标与对照组相近，差异均无统计学意义 （均P ＞0.05 ）。治疗组留置导尿管天数与尿路感染发生率均低于对照组，差异均有统计学意义（均P 0.05 ）。结论 盆底肌电刺激法 和膀胱训练法均可改善不完全脊髓损伤术后患者的排尿功能，但盆底肌电刺激法恢复速度优于膀胱训练法，应早期应用。 【关键词】 电刺激 膀胱训练 脊髓 对照研究 Postoperative treatment of urinary dysfunction in patients with incomplete spinal cord injury: electrical pelvic floor stimulation versus bladder training therapy China 【Abstract 】 Objective To compare electrical pelvic floor stimulation with bladder training therapy in treatment of urinary dysfunction in patients with incomplete spinal cord injury after operation. Methods Seventy three patients with incomplete spinal cord injury were randomly assigned to study group(n=35) and control group (n=38). Patients in study group was given electrical pelvic floor stimulation while those in control group were given bladder training therapy for urinary dysfunction. Residual volume of urine was evaluated with ultrasonography, the urinary function was assessed with urodynamic examinations, the urinary catheter extraction rate and the urinary tract infection rate were recorded. Results The successful rate of urinary catheter extraction rate in study group was significant higher than that in control group (P 0.05). The residue urine volume (RUV), maximum urinary flow rate (MFR), average urinary flow rate (AFR), and detrusor pressure at peak flow (PdetQmax) after treatment were all higher than those bef