新型变频刺激模式骶神经调控术对逼尿肌过度活动伴收缩功能受损的疗效评估  

Evaluation of the efficacy of a new variable frequency stimulation sacral neuromodulation in the treatment of detrusor hyperactivity with impaired contractility

作　　者：朱文[1] 单帅帅 张钦涌 张静[3] 张晨阳[1] 王钏宇 贾智明 张国贤[1] 王焱[1] 车英玉[3] 文建国[2] 王庆伟[1] Wen Zhu;Shuaishuai Shan;Zhang Qinyong;Zhang Jing;Zhang Chenyang;Wang Chuanyu;Jia Zhiming;Zhang Guoxian;Wang Yan;Che Yingyu;Wen Jianguo;Wang Qingwei(Department of Urology,the First Affiliated Hospital of Zhengzhou University,Henan 450000,China;Henan Joint International Pediatric Urodynamic Laboratory,the First Affiliated Hospital of Zhengzhou University,Henan 450000,China;Department of Magnetic Resonance Imaging,the First Affiliated Hospital of Zhengzhou University,Henan 450000,China)

机构地区：[1]郑州大学第一附属医院泌尿外科,河南450000 [2]郑州大学第一附属医院小儿尿动力学国际联合实验室,河南450000 [3]郑州大学第一附属医院磁共振科,河南450000

出　　处：《中华医学杂志》2022年第2期147-151,共5页National Medical Journal of China

基　　金：国家自然科学基金(U1904208)。

摘　　要：分析2020年9月至2021年2月在郑州大学第一附属医院接受恒频更改为变频程控参数刺激骶神经调控疗法治疗12周的16例逼尿肌过度活动伴收缩功能受损(DHIC)患者的基线期、恒频刺激(CFS)期和变频刺激(VFS)期排尿日记、症状评分量表和不良事件发生情况。与CFS期相比,VFS期排尿日记每日排尿次数、每日尿失禁次数和每日平均导尿量减少;每日平均排尿量和功能性膀胱容量增加;生活质量评分和精神健康问卷评估改善(均P<0.05)。16例患者中有14例患者症状改善。并未见新发的植入部位疼痛和感染,电极移位以及刺激区域电击感等并发症。VFS模式骶神经调控疗法可进一步改善CFS刺激模式DHIC患者储尿期和排尿期下尿路症状,提高患者生活质量和治疗满意度,安全可靠。A total of 16 detrusor hyperactivity with impaired contractility(DHIC)patients who received 12 weeks remote variable frequency stimulation(VFS)were enrolled at the First Affiliated Hospital of Zhengzhou University from September 2020 to February 2021.The voiding diary,symptom score scales and incidence of complications were completed and recorded at baseline,constant frequency stimulation(CFS)and VFS phases.Compared with the CFS phase,voiding times,urge incontinence times and daily catheterization volume were reduced;average voiding amount and functional bladder capacity increased;and the quality of life score and mental health questionnaire assessment were improved in the VFS phase(all P<0.05).In the end,among all 16 patients,there were 14 whose symptoms had improved,and there were no new complications such as pain or infection at the implantation site,electrode displacement,and electric shock sensation in the stimulation area.VFS-SNM can not only improve the DHIC patients′lower urinary tract symptoms during storage and urination period,but also improve the patients′quality of life and satisfaction of the therapy.

关 键 词：膀胱 过度活动性 骶神经调控术 变频刺激 

分 类 号：R694[医药卫生—泌尿科学]