穿戴式经皮胫神经调控治疗膀胱过度活动症的疗效观察  

Clinical efficacy of a wearable percutaneous tibial neuromodulation for overactive bladder

作　　者：刘一茜 廖利民[1] 陈国庆[1] 邓函 李兴 吴娟[1] Liu Yixi;Liao Limin;Chen Guoqing;Deng Han;Li Xing;Wu Juan(School of Rehabilitation,Capital Medical University,Urology Department/Urinary and Pelvic Floor Rehabilitation Center,China Rehabilitation Research Center,Bejing Bo'ai Hospital,China Rehabilitation Science Institute,Beijing 100068,China)

机构地区：[1]首都医科大学康复医学院、中国康复研究中心北京博爱医院泌尿外科/泌尿与盆底康复中心、中国康复科学所,北京100068

出　　处：《中华泌尿外科杂志》2024年第9期671-675,共5页Chinese Journal of Urology

基　　金：首都卫生发展科研专项课题(首发2022-1-6011)。

摘　　要：目的探讨采用穿戴式经皮胫神经刺激治疗膀胱过度活动症(OAB)的有效性和安全性。方法本研究采用单中心、前瞻性、开放性临床试验设计,纳入北京博爱医院泌尿外科门诊2023年7月至2024年6月收治的OAB患者。所有患者均符合OAB诊断标准。所有患者均接受频率20 Hz、脉宽0.2 ms,每次30 min,每日2次,为期12周的穿戴式经皮胫神经刺激治疗。在治疗的第4周、第8周及第12周对患者进行随访评估,评估内容包括72 h排尿日记、OAB症状评分(OABSS)、膀胱状态感知量表评分(PPBC-S)、美国泌尿协会症状指数评分(AUA-SI)、美国泌尿协会症状指数生活质量评分(AUA-SI-QOL),记录不良事件。结果共纳入68例患者。其中男28例,女40例;年龄(49.6±9.0)岁,体质量指数(23.2±2.5)kg/m 2;病程(42.0±14.4)个月。治疗12周后,患者每日的排尿次数由治疗前的(18.5±3.9)次下降至(10.3±4.5)次,夜尿次数由(6.5±2.2)次下降至(3.9±2.0)次,每日漏尿量由(796.5±140.0)ml下降至(534.8±135.8)ml,OABSS由(12.6±2.8)分下降至(9.8±3.8)分,PPBC-S由(5.5±0.6)分下降至(3.8±1.2)分,AUA-SI由(25.5±2.2)分下降至(16.6±3.6)分,AUA-SI-QOL由(5.5±0.5)分下降至(3.7±1.1)分,治疗前后上述指标的差异均有统计学意义(P<0.05)。治疗过程中,未发生与设备相关的严重不良事件,未发生麻木、刺痛等神经相关不良事件。结论穿戴式经皮胫神经刺激可有效缓解患者的尿频、尿急等OAB症状,不良反应少,为OAB患者提供了新的治疗选择。Objective To investigate the efficacy and safety of a wearable percutaneous tibial nerve stimulator(TTNS)for tibial neuromodulation(TNM)in the treatment of overactive bladder(OAB).Methods This research utilizes a single-center,prospective,open clinical trial design.Patients with OAB who were treated at the urology outpatient department of Beijing Bo'ai Hospital from July 2023 to June 2024 were enrolled.All patients met the diagnostic criteria for OAB.All patients received a transcutaneous tibial nerve regulation stimulation therapy,with a frequency of 20 Hz and a pulse width of O.2 ms.The treatment lasted for 30 minutes each session,twice daily,for a duration of 12 weeks.Follow up evaluations were conducted at weeks 4,8,and 12 after treatment,including a 72-hour voiding diary,Overactive Bladder Symptom Score(OABSS),patient perception of bladder condition scale(PPBC-S)score,American Urological Association Symptom Index(AUA-SI)score,American Urological Association Symptom Index Quality of Life Score(AUA-SI-QOL)score,vital signs,and adverse events.Results This study included 68 patients,with 28 males and 40 females.Their mean age was(49.6±9.0)years old,the body mass index was(23.2±2.5)kg/m^(2).The duration of the disease was(42.0±14.4)months.After 12 weeks of intervention,patients daily urination frequency decreased from(18.5±3.9)times to(10.3±4.5)times,nocturia frequency decreased from(6.5±2.2)times to(3.9±2.0)times,daily urine leakage decreased from(796.5±140.0)ml to(534.8±135.8)ml,OABSS decreased from(12.6±2.8)to(9.8±3.8),PPBC-S decreased from(5.5±0.6)to(3.8±1.2),AUA-SI decreased from(25.5±2.2)to(16.6±3.6),and AUA-SI-QOL decreased from(5.5±0.5)to(3.7±1.1).The differences in the above indicators before and after treatment were statistically significant(P<0.05).During the treatment process,there were no serious adverse events related to the equipment,and no neurological related adverse events such as numbness or tingling occurred.Conclusions The application of wearable percutaneous tibial nerve sti

关 键 词：经皮神经电刺激 胫神经调控 穿戴式 膀胱过度活动症 无创治疗 

分 类 号：R694.5[医药卫生—泌尿科学]