功能性电刺激联合膀胱功能训练对男性脊髓损伤后神经源性膀胱尿动力学及性功能的影响  

Effects of functional electrical stimulation combined with bladder function training on neurogenic bladder urodynamics and sexual function after spinal cord injury in males

作　　者：游云超 李春茂[1] 杨烁[1] 张杰 张金燕[1] You Yunchao;Li Chunmao;Yang Shuo;Zhang Jie;Zhang Jinyan(Department of Urology Surgery,Dazhou integrated TCM&Western Medicine Hospital,Dazhou Sichuan,635000)

机构地区：[1]四川省达州市中西医结合医院泌尿外科

出　　处：《现代仪器与医疗》2019年第4期37-40,45,共5页Modern Instruments & Medical Treatment

基　　金：四川省中医药管理项目，编号201047;达州市医学科研项目，编号201616

摘　　要：目的:探讨功能性电刺激联合膀胱功能训练对男性脊髓损伤后神经性膀胱尿动力学及性功能的影响。方法:选择2015年1月至2018年1月在我院接受治疗的脊髓损伤后神经源性膀胱男患者78例进行研究。采用随机数字表法将患者分为2组,每组各39例。对照组行常规功能训练,观察组在此基础上加以功能性电刺激治疗。对比两组患者疗效、尿动力学参数、性功能、达到平衡膀胱状态例数及时间。结果:观察组有效率为97.43%,明显高于对照组的84.62%(P<0.05)。干预后两组患者最大逼尿肌收缩压、残余尿量明显下降,但观察组下降幅度更大,组间差异有统计学意义(P<0.05),干预后两组膀胱容量、膀胱顺应性、国际勃起功能指数问卷-5及射精功能评分明显升高,但观察组升高更明显,组间差异有统计学意义(P<0.05)。观察组达到平衡膀胱状态例数明显大于对照组,达到平衡膀胱状态时间明显较对照组短,组间差异有统计学意义(P<0.05)。结论:功能性电刺激联合膀胱功能训练与单纯膀胱功能训练相比,可明显改善男性男性脊髓损伤后神经性膀胱尿动力学及性功能,帮助恢复平衡膀胱状态。Objective: To investigate the effects of functional electrical stimulation combined with bladder function training on neurogenic bladder urodynamics and sexual function in male patients with spinal cord injury. Methods: A total of 78 male patients with neurogenic bladder after spinal cord injury who were treated in our hospital from January 2015 to January 2018 were enrolled.Patients were divided into 2 groups using a random number table method, with 39 cases in each group. The control group underwent routine functional training, and the observation group was given functional electrical stimulation therapy. The efficacy, urodynamic parameters, sexual function, number of cases of balanced bladder status and time were compared between the two groups. Results: The effective rate of the observation group was 97.43%, which was significantly higher than that of the control group (84.62%)(P<0.05). After intervention, the maximum detrusor systolic pressure and residual urine volume decreased significantly in the two groups, but the decrease in the observation group was greater (P<0.05). After the intervention, the bladder volume, bladder compliance, IIEF-5 score and CIPE score were significantly different. Elevated, but the increase in the observation group was more significant (P<0.05). The number of cases in the observation group reaching the equilibrium bladder state was significantly higher than that in the control group, and the time to reach the equilibrium bladder state was significantly shorter than that in the control group (P<0.05). Conclusion: Functional electrical stimulation combined with bladder function training can significantly improve neurogenic bladder urodynamics and sexual function after spinal cord injury in males, and help restore balance of bladder status.

关 键 词：功能性电刺激 膀胱功能训练 男性 脊髓损伤后神经性膀胱 

分 类 号：R454.1[医药卫生—治疗学]