盆底肌生物反馈和电刺激联合针刺治疗脊髓损伤后神经源性膀胱的疗效

发布时间：2018-12-11 10:36

【摘要】：目的:观察盆底肌生物反馈和电刺激联合针刺八毼穴对脊髓损伤(SCI)后神经源性膀胱(NB)的临床疗效。方法:60例SCI后NB患者,随机分为针刺治疗组(对照A组)、盆底肌生物反馈和电刺激治疗组(对照B组)以及盆底肌生物反馈和电刺激联合针刺治疗组(联合组),每组20例,均执行每日定时定量饮水和定时间歇清洁导尿;分别于治疗前后行尿流动力学检查比较患者的膀胱安全容量、残余尿量,患者通过排尿日记记录自解小便次数、漏尿次数、清洁导尿次数以及尿路感染情况。结果:与治疗前比较,治疗8周后3组患者最大膀胱安全容量和残余尿量均有一定程度改善(P0.05);联合组患者的膀胱安全容量和残余尿量明显优于对照A组和对照B组(P0.05);治疗后,3组患者的每次尿量增加,日排尿次数明显减少,漏尿和清洁导尿次数明显减少(P0.05),其中以联合组减少最明显(P0.05);治疗后,3组患者自解小便次数均明显减少(P0.05),3组之间比较差异无统计学意义(P0.05)。结论:针刺八毼穴、盆底肌生物反馈和电刺激治疗均能改善SCI后NB患者的排尿功能,而两者联合治疗效果更好。
[Abstract]:Objective: to observe the clinical effect of pelvic floor muscle biofeedback and electrical stimulation combined with acupuncture at Bazhang point on neurogenic bladder (NB) after spinal cord injury (SCI). Methods: sixty patients with NB after SCI were randomly divided into acupuncture treatment group (control group A), pelvic floor muscle biofeedback and electrical stimulation group (control group B) and pelvic floor muscle biofeedback and electric stimulation combined with acupuncture treatment group (combined group). 20 cases in each group were given daily regular drinking water and intermittent cleaning catheterization. The urinary bladder safety volume and residual urine volume were compared before and after treatment. The patients recorded the times of self-explaining urine, the times of leakage, the times of clean catheterization and the condition of urinary tract infection. Results: compared with before treatment, the maximal bladder safe volume and residual urine volume in the 3 groups were improved to some extent after 8 weeks of treatment (P0.05). The safe bladder volume and residual urine volume in the combined group were significantly better than those in the control group A and B (P0.05). After treatment, the amount of urine in each of the three groups increased, the number of urination per day decreased significantly, the times of leakage and clean catheterization decreased significantly (P0.05), especially in the combined group (P0.05). After treatment, the number of self-resolving urination in the three groups were significantly reduced (P0.05), there was no significant difference between the three groups (P0.05). Conclusion: acupuncture at Bazhou point, pelvic floor muscle biofeedback and electrical stimulation can improve the urination function of NB patients after SCI, and the combined therapy is more effective.
【作者单位】：重庆医科大学附属四川省康复医院四川省八一康复中心;遂宁市中心医院;
【基金】：四川省卫生厅科研项目(编号:130494)项目名称:操作性肌电生物反馈疗法对胸腰段不完全性脊髓损伤患者下肢表面肌电信号和肌力的影响
【分类号】：R651.2

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