摘要
目的评估生物反馈训练联合神经电刺激对严重功能性排尿障碍儿童的治疗效果。方法2016年12月至2018年12月,中国医科大学附属盛京医院小儿泌尿外科对收治的28例6~15岁传统治疗无效的功能性排尿障碍儿童进行生物反馈联合电刺激治疗,其中女童12例,男童16例。主要症状为日间遗尿(89.2%),尿急迫(82.1%),夜间遗尿(39.4%)。尿流动力学检查结果显示,膀胱过度活动和逼尿肌括约肌协调障碍分别占92.9%和71%。在治疗前教育的基础上,采用无创会阴表面电极进行生物反馈结合神经电刺激疗法对上述患儿进行治疗,一个疗程2周,共20次。在治疗期间和治疗后,指导患儿进行如厕和盆底训练。结果末次治疗6个月后随访结果:日遗尿患儿治愈率40%,好转率46.4%;夜间遗尿患儿治愈率18%,好转率54.5%。治疗12个月后随访结果:日遗尿患儿治愈率56.5%,好转率39.2%,夜间遗尿患儿治愈率和好转率均为36.4%。结论短期高频度针对盆底功能训练的生物反馈联合电刺激治疗学龄期重症DV无创、有效,可考虑对该疗法的疗效进行大规模随机对照研究,并制定相应的规范治疗程序。
Objective The aim of this study was to assess the treatment and efficacy of a biofeedback Biofeedback training program combined with electrical stimulation in children with serious dysfunctional voiding.Methods Between Dec 2016 to December 2018,28 children with dysfunctional voiding who did not respond to traditional treatment,aged 6-15 years,were treated.There were 12 girls and 16 boys.The main symptoms were diurnal enuresis for 89.2%,Urine urgency for 82.1%,and nocturnal enuresis for 39.4%.overactive bladder or detrusor-sphincter dyscoordination was noted in 92.9%,71%respectively of the children.With the pre-treatment education,Biofeedback therapy combined with electrical nerve stimulation were planned for all the children,non-invasive surface perineal electrodes were used during the procedure.One training course was 2 weeks with 20 session.The children were given instructions on toilet behaviour and pelvic floor training during and after the treatment.The exercises focused on relaxation of the perineum and training of the pelvic floor.Results The first results were recorded 6 months after the last session:40%,46.4%of the children with diurnal enuresis and 18%,54.5%of the children with nocturnal enuresis were cured and improved respectively;During the 12-month follow-up,56.5%,39.2%of the children with diurnal enuresis and 36.4%,36.4%of the children with nocturnal enuresis were cured and improved respectively.Conclusion Short term high frequency biofeedback combined with electrical stimulation therapy for pelvic floor function training was non-invasive and effective in the treatment for school-age children with severe DV.It is necessary to carry out large-scale randomized controlled study on the efficacy of this treatment and to standardize the procedure.
作者
牛之彬
杨屹
Niu Zhibin;Yang Yi(Department of Pediatric Urology,Affiliated Shengjing Hospital,Shenyang 110004,China,Shenyang,Liaoning Province)
出处
《临床小儿外科杂志》
CAS
2020年第11期991-995,共5页
Journal of Clinical Pediatric Surgery
基金
国家自然科学基金项目:去分化脂肪细胞对PBOO所致膀胱损伤中TGF/Smad通路的调控及其机制研究(项目批准号:81701531)。
