重复功能性磁刺激骶神经根治疗脊髓损伤后尿潴留的临床效果:病例对照研究

Jing-Jing Zhang, Yan Chen, Lingsong Wu, Fang Gao, Yan Li, Bing-Chen An
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引用次数: 1

摘要

尿潴留是脊髓损伤的严重并发症。本研究探讨了骶神经根重复功能磁刺激(rFMS)是否影响脊髓损伤后尿潴留患者的膀胱功能或情绪。这项单中心病例对照研究纳入32例脊髓损伤后逼尿肌弛缓性神经源性膀胱患者,随机分为rFMS组(n = 11)、电针阴部神经刺激组(EAPNS;N = 11),对照组(N = 10)。各组均接受常规膀胱功能训练。rFMS组骶S3神经以5 Hz频率刺激,每天1次,连续4周。EAPNS组每日1次电刺激阴部神经,连续4周。对照组患者单独接受膀胱功能再训练。治疗4周后,三组患者均有显著改善(P < 0.05)。rFMS组原发性膀胱感觉、最大膀胱体积、最大膀胱压、残余尿明显高于其他两组(P < 0.05)。原发性膀胱感觉、最大膀胱容量、剩余尿量、尿白细胞计数在EAPNS组与对照组之间差异有统计学意义(P < 0.05)。rFMS组在焦虑自评量表和抑郁自评量表上的得分显著低于其他两组。三组患者的生活质量评分均显著提高。rFMS有利于尿潴留患者神经源性功能的恢复。本研究为rFMS的临床应用和推广提供了科学依据。
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Clinical effect of repetitive functional magnetic stimulation of sacral nerve roots on urinary retention after spinal cord injury: a case-control study
Urinary retention is a serious complication of spinal cord injury. This study examined whether repetitive functional magnetic stimulation (rFMS) applied over the sacral nerve root affected bladder function or mood in patients with urinary retention after spinal cord injury. This single-center, case-control study included 32 patients with detrusor flaccid neurogenic bladder after spinal cord injury, who were randomly assigned to rFMS (n = 11), electroacupuncture pudinal nerve stimulation (EAPNS; n = 11), and control groups (n = 10). All groups received routine bladder function training. The S3 sacral nerve was stimulated at a frequency of 5 Hz, once per day for 4 consecutive weeks in the rFMS group. Electroacupuncture stimulation of the pudendal nerve was performed once daily for 4 weeks in the EAPNS group. The control group received bladder function retraining alone. After the 4-week treatment, there were significant improvements in all three groups (P < 0.05). Primary bladder sensation, maximum bladder volume, maximum bladder pressure, and residual urine were significantly higher in the rFMS group than in the other two groups (P < 0.05). Primary bladder sensation, maximum bladder volume, residual urine, and urinary leukocyte count were significantly different between the EAPNS and control groups (P < 0.05). The rFMS group had significantly lower scores in the self-rated anxiety scale and self-rated depression scale compared with those of the other two groups. The quality of life score significantly increased in all three groups. rFMS is conducive to the recovery of neurogenic function in patients with urinary retention. This study provides a scientific basis for the clinical application and promotion of rFMS.
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