神经根刺激器在治疗脊髓损伤所致神经原性膀胱功能障碍的应用价值  

The application of nerve root stimulation system in the treatment of spinal cord injury caused by neurogenic bladder dysfunction

作　　者：王亮 谷欣 

机构地区：[1]仁康医院泌尿外科,广东东莞523000

出　　处：《岭南现代临床外科》2015年第4期483-485,共3页Lingnan Modern Clinics in Surgery

摘　　要：目的探讨神经根刺激器在治疗脊髓损伤所致神经原性膀胱功能障碍(NBD)的应用价值。方法选取2009年3月至2013年5月期间我院确诊治疗的脊髓损伤所致NBD患者72例,分刺激组和对照组,两组患者均给予每天2次口服托特罗定(2 mg/次)治疗,刺激组患者在此基础上给予神经根刺激治疗,其中刺激组依据治疗方法又分为骶神经电刺激(SNS)治疗组和神经肌肉电刺激(NES)治疗组,对所有患者进行为期3个月的随访,观察患者尿流动力学、尿道压力和日均排尿次数。结果在尿流动力学方面,NES组残余尿量和最大膀胱容量明显优于SNS组(P<0.017),而SNS组残余尿量与最大膀胱容量明显优于对照组(P<0.017);在逼尿肌压力水平与日均排尿次数方面,治疗后60 d,NES组明显优于对照组(P<0.017);治疗后120 d,NES组明显优于SNS组与对照组,SNS组明显优于对照组(P<0.017)。结论神经根刺激治疗有利于改善脊髓损伤所致NBD患者膀胱功能。Objective To discuss the value of nerve root stimulation system in the treatment of spinal cord injury caused by neurogenic bladder dysfunction（NBD）. Methods Seventy-two patients with NBD were selected in our Hospitals. All patients were divided into control group（n =24） and stimulating group（n=48）, two groups of patients were given oral tolterodain（2 mg / day） treatment. The stimulating group again divided into sacral nerve stimulation（SNS group, n=24） group and neuromuscular electrical stimulation（NES group, n =24） group, and got three-month follow-up. The urine flow mechanics, urethral pressure and average daily number of urination were analyzed. Results The residual urine volume and maximum bladder capacity in NES group were significantly better than that of SNS group（P〈0.017）, and residual urine volume and maximum bladder capacity in SNS group were significantly better than that of control group（P〈0.017）. After treatment for 60 days, the detrusor pressure level and the average urination frequency in NES group were significantly improved than in control group（P〈0.017）, and after treatment for 120 days, the effect in NES group were better than and control group and SNS group（P〈0.017）. Conclusion Nerve root stimulation treatment can improve bladder function of the patients with NBD.

关 键 词：神经根刺激器 脊髓损伤 神经原性膀胱功能障碍 

分 类 号：R651[医药卫生—外科学]