电刺激联合生物反馈治疗广泛性全子宫切除术后排尿困难临床分析  

Clinical effect analysis of electrostimulation combined with biofeedback therapy for patients with dysuria after radical hysterectomy

作　　者：谢咏[1] 朱瑜苑 管玉涛 潘智茵 王刚[1] XIE Yong;ZHU Yu-yuan;GUAN Yu-tao;PAN Zhi-yin;WANG Gang(The First People’s Hospital of Foshan,Foshan 528000,China)

机构地区：[1]佛山市第一人民医院妇产科

出　　处：《中国实用妇科与产科杂志》2019年第11期1233-1238,共6页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：广东省科技计划项目（20130319c）

摘　　要：目的探讨电刺激联合生物反馈治疗广泛性全子宫切除术后排尿困难的临床效果,为评估电刺激对肿瘤患者术后的安全性提供临床参考。方法选取2013年1月至2016年1月在广东省佛山市第一人民医院因宫颈癌行广泛性全子宫切除术后出现排尿困难患者共40例,随访至2018年12月。按随机原则将其分为对照组、治疗组各20例。对照组给予标准治疗,治疗组同时增加骶神经根体表投影区、膀胱区、阴道内电刺激及生物反馈治疗;两组患者以膀胱感觉功能、国际下尿路症状评分、泌尿症状困扰评分、尿流动力学等为评价指标,分别于术后2周评估排尿困难的基线情况,术后8、12周评估治疗效果,并按肿瘤规范复诊,随访至少3年。结果随着时间延长,治疗组膀胱感觉功能恢复速度比对照组快,至术后12周,治疗组恢复正常膀胱感觉人数较对照组多1倍(16例、8例);术后8、12周,同时间段比较泌尿症状困扰评分、国际下尿路症状评分各项指标均优于对照组(P<0.05);治疗组术后12周膀胱逼尿肌压力(44.31±5.51)cmH2O(1cmH2O=0.098kPa),接近正常水平,而对照组(38.11±5.81)cmH2O,存在差异(P<0.05)。所有患者在随访期内,暂未发现肿瘤复发临床征象。结论低频电刺激联合生物反馈治疗广泛全子宫切除术后排尿困难,安全有效,能够缩短排尿功能障碍恢复的时间,并改善患者生活质量。Objective To investigate the clinical efficacy and safety of electrostimulation combined with biofeedback therapy for patients with dysuria after radical hysterectomy and to provide clinical reference for the evaluation of safety of electrostimulation for tumors.Methods Totally 40 patients with dysuria which presented two weeks after radical hysterectomy for cervical cancer in Foshan First People’s Hospita were enrolled as research subjects,and they were randomly assigned into control group and experimental group,each with 20 cases.Patients in control group only received standard treatment,while standard treatment combined with electrostimulation and biofeedback treatment in sacral nerve root surface projection area,bladder area,vaginal respectively were carried out in experimental group.The baseline condition of dysuria of all cases were evaluated in two weeks after radical surgery.The therapeutic effect in the patients in two groups were evaluated according to the recovery of bladder sensory function,international lower urinary tract symptom score,urinary symptom distress score and urodynamic measurement at 8 weeks and 12 weeks after the operation,respectively.Also,regular and normative surveillance and follow-up for tumor were implemented.Results Through our study,we found that electrical stimulation combined with biofeedback thearpy will greatly shorten the recovery time of bladder sensory function,and 12 weeks after the operation,the number of patients who had normal bladder sensory function in experimental group was twice as many as that of the control group(16/8).In addition,at 8 and 12 weeks after operation,all indexs of the urinary symptom disturbance score and international lower urinary tract symptom score at the same period in the experimental group were superior to those in control group(P<0.05).Furthermore,the pressure of bladder detrusor muscle at 12 weeks after operation was(44.31±5.51)cm H2 O(1 cm H2 O=0.098 k Pa)in experimental group,which was close to the normal level,while it was only(38.11

关 键 词：宫颈肿瘤 广泛性全子宫切除术 排尿困难 电刺激 生物反馈 

分 类 号：R737.3[医药卫生—肿瘤]