骶神经调控治疗顽固性间质性膀胱炎/膀胱疼痛综合征的有效性及安全性  

Efficacy and safety of sacral neuromodulation in the treatment of refractory interstitial cystitis/bladder pain syndrome

作　　者：郑强平 张建忠[1] 王菲 张朝华[1] 张鹏[1] ZHENG Qiangping;ZHANG Jianzhong;WANG Fei;ZHANG Chaohua;ZHANG Peng(Department of Urology,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院泌尿外科,北京100020

出　　处：《现代泌尿外科杂志》2025年第2期152-156,160,共6页Journal of Modern Urology

摘　　要：目的分析骶神经调控(SNM)治疗顽固性间质性膀胱炎/膀胱疼痛综合征(IC/BPS)的长期疗效及安全性,为该疾病的诊治提供更多临床证据。方法回顾性分析2015年1月—2021年12月首都医科大学附属北京朝阳医院收治的27例顽固性IC/BPS患者的临床资料,患者均接受SNMⅡ期手术。用总体反应评估(GRA)SNMⅡ期患者的疗效,比较患者SNM术前及术后的日均排尿次数、日均夜尿次数、功能膀胱容量、O Leary-Sant评分、盆腔疼痛与尿频尿急症状(PUF)评分、生活质量(QoL)评分、疼痛视觉模拟量表(VAS)评分。结果术后随访(55.55±16.33)个月,27例患者中12例症状无缓解(GRA≤4分),15例症状得到缓解(GRA>4分),总体有效率55.56%(15/27)。相比于术前,SNMⅡ期术后患者的日均排尿次数[(28.74±13.84)次vs.(24.74±16.33)次]、O Leary-Sant评分[(30.19±5.35)分vs.(25.63±9.34)分]、PUF评分[(25.63±5.34)分vs.(22.04±8.29)分]、QoL评分[(5.67±0.55)分vs.(4.33±1.57)分]以及VAS评分[(8.04±1.91)分vs.(5.33±3.09)分]均明显改善,差异有统计学意义(P<0.05)。未发生切口感染、刺激器植入部位疼痛等并发症。结论SNM治疗顽固性IC/BPS安全有效,但也存在长期疗效减退或消失的风险,故应慎重选择合适的患者。Objective To summarize the long-term efficacy and safety of sacral neuromodulation(SNM)in treating refractory interstitial cystitis/bladder pain syndrome(IC/BPS),so as to provide clinical evidence for this therapeutic approach.Methods This study retrospectively analyzed the data of 27 patients with refractory IC/BPS treated at our hospital during Jan.2015 and Dec.2021.All patients underwent SNMⅡ.The therapeutic effects were evaluated with Global Response Assessment(GRA).The preoperative and postoperative daily urinary frequency,nocturia frequency,functional bladder capacity,O Leary-Sant score,pelvic pain,urgency and frequency(PUF)score,quality of life(QoL)score,and visual analogue scale(VAS)score were compared.Results During the follow-up of(55.55±16.33)months,12 patients showed no symptom relief(GRA≤4),while 15 experienced symptom relief(GRA>4),resulting in an efficacy rate of 55.56%(15/27).The average daily urination frequency decreased from(28.74±13.84)to(24.74±16.33)times,the O Leary-Sant score decreased from(30.19±5.35)to(25.63±9.34),PUF score decreased from(25.63±5.34)to(22.04±8.29),QoL score decreased from(5.67±0.55)to(4.33±1.57),and VAS score decreased from(8.04±1.91)to(5.33±3.09),the differences were statistically significant(P<0.05).No complications such as incision infections or pain at the implant site were observed.Conclusion SNM is safe and effective for refractory IC/BPS,but there is a risk of long-term failure.Therefore,patients should be discreetly selected.

关 键 词：骶神经调控 间质性膀胱炎 膀胱疼痛综合征 

分 类 号：R694.3[医药卫生—泌尿科学]