腹腔镜前列腺癌根治术后电生理技术早期干预恢复控尿功能的临床疗效观察  

Observation of clinical efficacy of early electrophysiological technology intervention in restoring urine control function after laparoscopic radical resection of prostate cancer

作　　者：魏健文 尹文俊 陈泽楷 凌木安 陈洁[1] 潘斌[1] Wei Jianwen;Yin Wenjun;Chen Zekai;Ling Muan;Chen Jie;Pan Bin(Department of Urology,The First Affiliated Hospital of Jinan University,Guangzhou 510630,China)

机构地区：[1]暨南大学附属第一医院泌尿外科,广州510630

出　　处：《国际医药卫生导报》2022年第8期1038-1041,共4页International Medicine and Health Guidance News

基　　金：国家自然科学基金(81871155);广州市科技计划项目(202102080043);领航专科建设专项-暨南大学附属第一医院(711006);国家卫健委医药卫生科技发展研究中心重大专项(HDSL202001010)。

摘　　要：目的探讨腹腔镜前列腺癌根治术后电生理技术早期干预恢复控尿功能的临床疗效。方法选取2021年7月至12月暨南大学附属第一医院泌尿外科5例前列腺癌患者接受腹腔镜前列腺癌根治术,术后3 d采用电生理技术早期干预,年龄(63.20±6.14)岁。术式均为筋膜间腹腔镜前列腺癌根治术,术中膀胱尿道无张力吻合后,行膀胱颈前壁与耻骨前列腺韧带缝合。术后第3天进行可视化电生理诊断与治疗。治疗后对5例患者进行国际尿失禁咨询委员会尿失禁问卷表简表(ICI-Q-SF)评分、尿失禁生活质量问卷(I-QOL)评分及24 h尿垫使用量。结果所有患者均顺利完成手术,手术时间(5.92±1.35)h,出血(42.00±10.95)ml,盆腔引流管拔除时间(4.20±1.10)d,1例术后出现发热,对症处理后好转。术后2周拔除尿管,5例患者均大力咳嗽时出现少许漏尿,1例患者拔尿管当天使用了1片尿垫,24 h尿垫使用量≤1片,4例未使用尿垫,评估为术后早期恢复控尿功能。治疗周期(7.40±1.52)d,治疗后ICI-Q-SF评分(2.80±1.64)分,I-QOL评分(94.00±3.08)分。结论腹腔镜前列腺癌根治术后电生理技术早期干预恢复控尿功能安全有效,有望在未来对前列腺癌根治术后早期恢复控尿功能治疗中成为标准的辅助疗法。Objective To investigate the clinical efficacy of early electrophysiological technology intervention in restoring urine control function after laparoscopic radical resection of prostate cancer.Methods Five patients aged(63.20±6.14)years with prostate cancer enrolled in the Department of Urology of The First Affiliated Hospital of Jinan University from July to December 2021 received electrophysiological intervention on the third day after laparoscopic radical resection of prostate cancer.The laparoscopic radical resection of prostate cancer was performed between pelvic fascia and prostatic fascia.Tension-free anastomosis was made between the bladder and proximal urethra,and then the anterior wall of the bladder neck and the pubic prostate ligament were stitched up.On the third day,a medical infrared thermal imaging instrument(PRISM 640A/PRISM 384A)was used to visualize the electrophysiological diagnosis,the individual electrophysiological parameters were selected,and then the precise electrophysiological treatment was conducted(low-frequency neuromuscular therapy instrument model:BioStim pro and BioStim ble Foshan Shanshan Datang Medical Technology Co.,LTD.).Electrophysiological treatment parameters and electrode tablet adhesive locations:BB8:10 Hz/300μs for arterial circulation,BB16:2 Hz/280μs for venous circulation,BB27:48 Hz/180μs for arterial circulation,BB30:10 Hz/480μs for lymphatic circulation;EE21:36 Hz/300μs for vascular smooth muscle;electrode tablets were affixed at"curved bone,triple Yin"acupoints.DD1:8 Hz/500μs,20 Hz/350μs for classⅠskeletal muscle,DD211:25 Hz/500μs for classⅠskeletal muscle,DD297:36 Hz/350μs for classⅡskeletal muscle,DD211 and DD297 alternatively;electrode tablets were attached to the pelvic floor muscles.CC16:25 Hz/300μs for pudendal nerves,CC39:96 Hz/150μs for sympathetic nerves,electrode tablets were affixed to the"curved bone,sacral eight points"acupoints,consecutive treatment for 5-9 times.After treatment,International Incontinence Advisory Committee Incontinen

关 键 词：电生理适宜技术 可视化个体化治疗 腹腔镜前列腺癌根治术 早期尿控 

分 类 号：R737.25[医药卫生—肿瘤]