骶神经根功能性磁刺激对脊髓损伤后神经源性膀胱过度活动症的作用

The effects of functional magnetic stimulation in patients with neurogenic overactive bladder

中文关键词:  功能性磁刺激  脊髓损伤  神经源性膀胱过度活动症

英文关键词:Functional magnetic stimulation  Spinal cord injury  Neurogenic overactive bladder

中文摘要:

  【摘要】 目的：观察骶神经根功能性磁刺激（functional magnetic stimulation，FMS）对脊髓损伤患者神经源性膀胱过度活动症（overactive bladder，OAB）治疗的效果。方法：将40例脊髓损伤后OAB患者按随机数字表法分为治疗组（20例）和对照组（20例）。两组患者均给予常规的膀胱功能干预，治疗组在此基础上给予骶神经根FMS（强度为70％～100％最大输出强度，频率15Hz，每分钟刺激5s，共刺激30min，每日1次，每周5次，共治疗8周），对照组则给予相同参数FMS（刺激线圈与治疗部位垂直，无刺激作用）。两组患者均于治疗前和8周后比较尿流动力学指标（初尿意时膀胱容量、最大膀胱测压容量、残余尿量）、排尿日记指标（单次尿量、排尿次数和最大排尿量）及因排尿不良而引起生活质量评分变化。结果：治疗8周后，两组患者尿流动力学及排尿日记指标较术前均显著改善。初尿意时膀胱容量（对照组65.25±6.41ml、治疗组78.44±9.52ml）增加（P<0.05），最大膀胱测压容量（对照组339.55±36.75ml、治疗组394.46±36.68ml）显著增加（P<0.05），残余尿量（对照组120.22±40.35ml、治疗组88.25±33.61ml）明显减少（P<0.05）；日均单次排尿量（对照组120.06±23.23ml、治疗组150.28±24.24ml）增加（P<0.05），24h平均排尿次数（对照组12.28±3.31、治疗组9.44±3.95）减少（P<0.05），最大排尿量（对照组233.58±47.14ml、治疗组274.51±30.18ml）显著改善（P<0.05）；因排尿症状而引起生活质量评分均明显降低；与组内治疗前比较，差异均有统计学意义（P<0.05），且治疗组改善情况均显著优于对照组（P<0.05）。结论：FMS可改善神经源性膀胱过度活动症患者的膀胱功能和提高患者的生存质量。

英文摘要:

  【Abstract】 Objectives: To explore the effects of functional magnetic stimulation(FMS) in patients with neurogenic overactive bladder after spinal cord injury. Methods: Forty patients with neurogenic overactive bladder after spinal cord injury were randomly divided into FMS group(20 patients) and control group(20 patients) by using a random number table． Both groups received the functional training of bladder, the FMS group was additionally given FMS(The intensity was 70%-100% of the maximum output intensity, the frequency was 15Hz, and the stimulation was 5s every minute for a total of 30min, once a day, five times a week, for a total of 8 weeks), the control group was given same parameter FMS(but the stimulation coil was perpendicular to the treatment site and had no stimulation effect)． Urodynamics, urination diary record indexes(single urine volume, number of urination and maximum urination volume) and quality of life score changes caused by urination symptoms were compared between the two groups before and after treatments lasted for 8 weeks. Results: After 8-week treatment, the urodynamic indexes of the control and FMS groups were as follows: bladder volume(65.25±6.41ml, 78.44±9.52ml) increased at first urine intention (P<0.05), maximum bladder manometric capacity(339.55±36.75ml, 394.46±36.68ml) increased significantly(P<0.05), and residual urine volume(120.22±40.35ml, 88.25±33.61ml) decreased significantly(P<0.05). The daily average single urination volume(120.06±23.23ml, 150.28±24.24ml) increased(P<0.05), the average 24-hour urination frequency(12.28±3.31, 9.44±3.95) decreased(P<0.05), and the maximum urination volume(233.58±47.14ml, 274.51±30.18ml) improved significantly(P<0.05). The quality of life score was significantly reduced due to urination symptoms. Compared within group before treatment, the difference was statistically significant(P<0.05), and the improvement of the treatment group was significantly better than that of the control group (P<0.05). Conclusions: FMS can improve the bladder function and the quality of life in patients with neurogenic overactive bladder．