盆底肌电刺激治疗脊髓损伤后神经源性膀胱的疗效观察

摘要

目的:探讨盆底肌电刺激(PES)对脊髓损伤(SCI)后膀胱功能障碍的疗效.方法:60例完全性SCI患者随机分为常规治疗组和PES组,每组30例,常规治疗组采用间歇导尿、激发排尿技术或Crede 手压法、Valsalva屏气法;PES组采用PES联合常规康复治疗.治疗前、治疗后分别评定患者日排尿次数,平均膀胱容量、最大排尿量、残余尿量、生存质量评分和国际下尿路症状(LUTS)评分等.结果:2个月的疗程结束后,两组患者日排尿次数减少、平均膀胱容量增加、最大排尿量、残余尿量减少,排尿症状有显著改善(P<0.05),生存质量评分和国际LUTS症状评分差异有显显著意义(P<0.05),PES组明显优于常规治疗组(P<0.05).结论:PES联合常规膀胱功能训练对治疗SCI患者神经源性膀胱的疗效优于常规的膀胱功能训练.%Objective: To explore the effects of pelvic floor electrical stimulation(PES) on neurogenic bladder in patients with spinal cord injury(SCI).Method: Sixty patients with SCI were randomly divided into two groups:PES group and conventional therapy group, thirty patients in each group. Conventional therapy group was treated with intermittent catheterization,provocative urination maneuver or Crede maneuver, Valsalva maneuver: PES group was treated with PES combined with conventional therapy. The effects of two groups were assessed with urination frequency, average bladder capacity,maximum urinary output,residual urine,quality of life, international scores of lower urinary tract symptom (LUTS) before and after treatment.Result: The urination frequency, the average bladder capacity,maximum urinary output,residual urine quality of life, and international scores of LUTS improved significantly in patients two months after treatment(P＜0.05), Curative effect of PES group was significantly better than that of conventional therapy group(P＜0.05).Conclusion: Curative effect of PES combined with conventional therapy was significantly better than that of conventional therapy for the neurogenic bladder in patients with SCI.