低频电刺激联合间歇导尿及Motomed运动训练对脊髓损伤致神经源性膀胱患者膀胱内压力及膀胱容量的影响

目的:探讨低频电刺激联合间歇导尿及Motomed运动训练对脊髓损伤致神经源性膀胱患者膀胱内压力及膀胱容量的影响。方法:选取我院2015年12月～2018年2月收治的脊髓损伤致神经源性膀胱患者92例,根据随机数字表法将其分为对照组(n=46)与研究组(n=46)。两组均给予间歇性导尿、盆底肌训练、膀胱功能训练等常规干预,对照组在此基础上采取低频电刺激,研究组于对照组基础上采取Motomed运动训练,两组均干预2个月。比较两组的临床疗效、治疗前及治疗2个月后的排尿情况(日均单次排尿量、日单次最大排尿量、日均排尿次数)、尿动力学情况(最大尿流率、膀胱容量、残余尿量、膀胱内压力)、LUTS(国际下尿路症状评分)及USDS(泌尿症状困扰评分)。结果:治疗后,研究组总有效率(93.48%)显著高于对照组(78.26%)(P0.05);治疗2个月后,两组日均单次排尿量、日单次最大排尿量、日均排尿次数、最大尿流率、膀胱容量、膀胱内压力均较治疗前显著增多,且研究组以上指标均明显高于对照组(P0.05);两组LUTS及USDS分值均较治疗前显著降低,且研究组以上指标均显著低于对照组(P0.05)。结论:间歇导尿联合低频电刺激与Motomed运动训练可有效改善脊髓损伤致神经源性膀胱患者尿动力学状态及排尿情况,增大膀胱容量及膀胱内压力等,缓解下尿路症状及泌尿症状困扰程度,提高治疗效果。

Effects of Low Frequency Electrical Stimulation Combined with Intermittent Catheterization and Motomed Exercise Training on the Intravesical Pressure and Bladder Volume of Patients with Neurogenic Bladder Caused by Spinal Cord Injury

ABSTRACT Objective: To investigate the effects of low-frequency electrical stimulation combined with intermittent catheterization and Motomed exercise training on intravesical pressure and bladder volume in patients with neurogenic bladder caused by spinal cord in- jury. Methods: A total of 92 patients with neurogenic bladder caused by spinal cord injury from December 2015 to February 2018 were enrolled in our hospital, divided into control group (n=46) and study group (n=46) as the random number table method. Give routine in- terventions to both groups, such as intermittent catheterization, pelvic floor muscle training, bladder function training, etc. On this basis, the control group took low-frequency electrical stimulation, and the study group took Motomed exercise training on the basis of the con- trol group, and both interventions were proceeding for 2 months. The clinical efficacy of the two groups, the urination before treatment and 2 months after treatment (daily average urine output, daily maximum urine output, daily average urination), urodynamics (maximum urinary flow rate, bladder capacity, Residual urine volume, intravesical pressure), LUTS (international lower urinary tract symptom score) and USDS (urinary symptom symptom score) were counted. Results: The total effective rate of the study group (93.48%) was higher than that of the control group (78.26%)(P<0.05); the average daily urine output, the daily maximum urine output, maximum urinary flow rate, bladder volume and bladder pressureand the daily average urination frequency increased after treatment for 2 months, and the study group was more than the control group(P<0.05); After 2 months of treatment, the LUTS and USDS scores of the two groups were lower than those before treatment, and the study group was lower than the control group(P<0.05). Conclusion: Intervention of intermittent catheteri- zation, low-frequency electrical stimulation and Motomed exercise training for patients with neurogenic bladder caused by spinal cord injury can effectively improve the urodynamic state and urination of patients, increase bladder capacity and intravesical pressure, etc. Uri- nary tract symptoms and urinary symptoms are bothered to improve the treatment of the disease.