膀胱腔內電刺激結合輔助訓練對神經源性膀胱活動低下患者尿流動力學的影響

【摘要】 目的：探討膀胱腔內電刺激（IVES）結合輔助訓練對神經源性膀胱活動低下（NUB）患者尿流動力學的影響。方法：選取2020年5月—2021年6月興國縣中醫院收治的66例NUB患者作為本次研究對象，通過隨機數字表法將其分為兩組，各33例。對照組采用間歇性清潔導尿和膀胱功能輔助訓練，觀察組則給予IVES結合膀胱功能輔助訓練。比較兩組治療前后的排尿日記，對兩組治療前后尿流動力學指標（最大尿流率、最大膀胱容量、最大尿流率時膀胱壓、殘余尿量）進行比較，評估兩組下尿路癥狀（LUTS）、生活質量及并發癥發生率。結果：與對照組相比，治療后觀察組單次排尿量明顯更高，排尿次數和尿失禁次數均更低（Plt;0.05）；治療后兩組尿流動力學指標均有所改善，觀察組最大尿流率、最大膀胱容量、最大尿流率時膀胱壓均明顯高于對照組，殘余尿量少于對照組（Plt;0.05）；與對照組相比，治療后觀察組尿失禁生活質量問卷（I-QOL）評分明顯更高，LUTS評分更低（Plt;0.05）；觀察組并發癥總發生率為6.06%，明顯低于對照組的24.24%（Plt;0.05）。結論：IVES結合輔助訓練應用于NUB患者的治療中，有利于改善患者排尿功能和尿流動力學指標，同時能有效提高其生活質量，降低并發癥發生率。

【關鍵詞】 神經源性膀胱 逼尿肌活動低下 膀胱腔內電刺激 尿流動力學

The Effect of Intravesical Electrical Stimulation Combined with Auxiliary Training on Urodynamic in Patients with Neurogenic Underactive Bladder/LI Jianxing. //Medical Innovation of China， 2023， 20（31）： 0-063

[Abstract] Objective： To investigate the effect of intravesical electrical stimulation （IVES） combined with auxiliary training on urodynamic in patients with neurogenic underactive bladder （NUB）. Method： A total of 66 NUB patients admitted to Xingguo Hospital of Traditional Chinese Medicine from May 2020 to June 2021 were selected as the objects of this study， and were divided into two groups according to random number table method， with 33 cases in each group. The control group received clean intermittent catheterization and bladder function auxiliary training， and the observation group received IVES combined with bladder function auxiliary training. The voiding diary between the two groups were compared before and after treatment. Urodynamic indexes （maximum flow rate， maximal bladder capacity， bladder pressure at maximum urine flow， residual urine volume） were compared between the two groups before and after treatment. Lower urinary tract symptoms （LUTS）， quality of life and complication rate in both groups were evaluated. Result： Compared with the control group， after treatment， the single urination volume in the observation group was significantly higher， the times of urination and urinary incontinence were lower （Plt;0.05）. After treatment， the urodynamic indexes of both groups were improved， the maximum flow rate， maximal bladder capacity and bladder pressure at maximum urine flow of the observation group were significantly higher than those of the control group， and the residual urine volume of the observation group was lower than that of the control group （Plt;0.05）. Compared with the control group， after treatment， incontinence quality of life questionnaire （I-QOL） score in observation group was significantly higher and LUTS score in observation group was lower （Plt;0.05）. The incidence of complications in the observation group was 6.06%， which was significantly lower than 24.24% in the control group （Plt;0.05）. Conclusion： IVES combined with auxiliary training in the treatment of NUB patients is beneficial to improve patients' urination function and urodynamic indexes， and can effectively improve their quality of life and reduce the incidence of complications.

[Key words] Neurogenic bladder Underactive detrusor Intravesical electrical stimulation Urodynamic

First-author's address： Xingguo Hospital of Traditional Chinese Medicine， Jiangxi Province， Xingguo 342400， China

doi：10.3969/j.issn.1674-4985.2023.31.014

臨床上將因神經調控機制出現紊亂，進而導致下尿路功能障礙的一種疾病稱為神經源性膀胱（NB），神經源性膀胱活動低下（NUB）是NB的類型之一，以排尿時間延長、流速減慢、膀胱排空不全等為典型臨床癥狀[1]。……