摘要
目的:评价阴部神经电针刺激疗法治疗前列腺根治术后尿失禁的临床疗效。方法:81例前列腺根治术后尿失禁患者,年龄(68.56±10.47)岁,病程(12.78±10.93)个月,按就诊时间随机分为观察组和对照组。对照组(n=40)采用经直肠盆底生物反馈联合电刺激疗法,3次/周,50 min/次,隔日1次;观察组(n=41)患者接受阴部神经电针刺激疗法,取骶四穴,电针3次/周,50 min/次,隔日1次,共治疗12周。分别记录两组患者治疗前,治疗4、8、12周及治疗后6个月随访的尿失禁问卷(ICI-Q-SF)、尿失禁生活质量(I-QOL)、尿失禁程度目视量表(VAS)、盆底肌力评估(Glazer),并对两组患者12周后疗效评价。结果:观察组患者治疗4、8、12周及6个月随访时ICI-Q-SF、I-QOL、VAS、Glazer评分均较治疗前有明显改善(P<0.05),且随着治疗时间的延长,效应不断累积,治疗12周及6个月随访时各项指标均较治疗4、8周有明显改善(P<0.05);对照组治疗8、12周及6个月随访时较治疗前各项指标有明显改善(P<0.05),随访时各项指标较治疗12周差异有统计学意义(P<0.05);与对照组比较,观察组在各时间点各项指标均较对照组改善更加明显(P<0.05),治疗12周观察组总有效率明显优于对照组[73.17%(30/41)vs 37.50%(15/40),P<0.05]。结论:阴部神经电针刺激疗法在前列腺根治术后尿失禁治疗方面安全有效,具有较好的远期疗效,可作为首选的保守治疗策略。
Objective:To evaluate the clinical effect of pudendal nerve electroacupuncture(EAP)on urinary incontinence after radical prostatectomy.Methods:According to the time of hospital visit,we randomly divided 81 patients,aged(68.56±10.47)years,with urinary incontinence after radical prostatectomy into a control(n=40)and an observation group(n=41),the former treated by transrectal pelvic floor biofeedback combined with electrical stimulation(qd alt,50 min/time)and the latter by EAP stimulation of the pudendal nerve at the four sacral points(qd alt,50 min/time),both for 12 weeks.Before,at 4,8 and 12 weeks of and 6 months after treatment,we obtained their scores on Urinary Incontinence Questionnaire Short Form(ICI-Q-SF),urinary incontinence quality of life(I-QOL),Visual Analogue Scale(VAS)and pelvic floor muscle strength(Glazer),and evaluated the effect of 12 weeks of treatment.Results:Compared with the baseline,the ICI-Q-SF,I-QOL,VAS and Glazer scores were significantly improved in the observation group at 4,8 and 12 weeks and during the 6-month follow-up(P<0.05),even more significantly at 12 weeks and 6 months than at 4 and 8 weeks(P<0.05),and also in the control group(P<0.05),even more significantly at 6 months than at 12 weeks(P<0.05).And all the indicators above were even better improved in the observation than in the control group at any point(P<0.05).The patients in the observation group showed a markedly higher rate of total effectiveness than the controls at 12 weeks(73.17%[30/41]vs 37.50%[15/40],P<0.05).Conclusion:EAP stimulation of the pudendal nerve is safe and has a good long-term effect in the treatment of urinary incontinence after radical prostatectomy,and therefore can be used as a first-choice conservative therapeutic strategy for this condition.
作者
杨浩
吕婷婷
吕笑
姚丽娟
吕坚伟
YANG Hao;LüTing-ting;LüXiao;YAO Li-juan;LüJian-wei(Department of Urology,Huzhou Hospital of Traditional Chinese Medicine,Huzhou,Zhejiang 313000,China;Department of Urology,South Section of Renji Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200112,China)
出处
《中华男科学杂志》
CAS
CSCD
北大核心
2020年第12期1119-1123,共5页
National Journal of Andrology
基金
湖州市科技计划项目(2018GYB37,2019GYB35)
关键词
前列腺根治术
尿失禁
阴部神经
电针
骶四穴
radical prostatectomy
urinary incontinence
pudendal nerve
electric acupuncture
four sacral points
